Individual
GUSTAVO TORRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2425 N MILWAUKEE AVE, CHICAGO, IL 60647-2627
(773) 772-2020
(773) 772-3320
Mailing address
2425 N MILWAUKEE AVE, CHICAGO, IL 60647-2627
(773) 772-2020
(773) 772-3320
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
467141
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007141
—
IL
Enumeration date
01/03/2007
Last updated
07/07/2008
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