# MILT88 INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245781269
- **Authorized official:** DR. MICHAEL TABERNACKI O.D. (PRESIDENT)
- **Authorized official phone:** (708) 601-2688

## Contact information

- **Practice address:** 6501 95TH ST, SEARS OPTICAL, CHICAGO RIDGE, IL 60415-2632
- **Practice address phone:** (708) 499-4676
- **Mailing address:** 3946 JOHNSON AVE, WESTERN SPRINGS, IL 60558-1139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 046-008140 | IL | Yes |

## Other

- **Enumeration date:** 10/14/2016
- **Last updated:** 10/14/2016