Organization
DR. CHARLOTTE F. NIELSEN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLOTTE F NIELSEN O.D. (PRESIDENT)
(847) 223-2000
Entity
Organization
Contact information
Practice address
1120 E WASHINGTON ST, GRAYSLAKE, IL 60030-7960
(847) 223-2000
Mailing address
1120 E WASHINGTON ST, GRAYSLAKE, IL 60030-7960
(847) 223-2000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008590
—
IL
Enumeration date
08/31/2007
Last updated
06/17/2008
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