Individual
DR. CRAIG MATTHEW DECLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6336 W GUNNISON ST, CHICAGO, IL 60630-2954
(773) 763-4666
(773) 763-4967
Mailing address
6336 W GUNNISON ST, CHICAGO, IL 60630-2954
(773) 763-4666
(773) 763-4967
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007272
IL
Other
Enumeration date
08/17/2005
Last updated
05/20/2008
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