Individual
IDA SIMONYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
330 N BRAND BLVD STE 110, GLENDALE, CA 91203-2308
(708) 423-1515
Mailing address
320 CHICAGO RIDGE MALL, CHICAGO RIDGE, IL 60415-2602
(708) 423-1515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011556
IL
Other
Enumeration date
08/03/2021
Last updated
07/17/2023
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