# CHITTICK FAMILY EYE CARE LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Leon Optometric Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336246552
- **Authorized official:** DR. SHAWN P MALLADY OD (PRESIDENT)
- **Authorized official phone:** (508) 837-3790

## Contact information

- **Practice address:** 1104 N VERMILION ST, DANVILLE, IL 61832-3094
- **Practice address phone:** (217) 398-2020
- **Practice address fax:** (217) 442-0119
- **Mailing address:** 1104 N VERMILION ST, DANVILLE, IL 61832-3094
- **Mailing address phone:** (217) 398-2020
- **Mailing address fax:** (217) 442-0119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0009X | Glaucoma Specialist (Ophthalmology) Physician | — | NULL | — |
| 207WX0009X | Glaucoma Specialist (Ophthalmology) Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 11/19/2024