Individual
JUSTIN TIMOTHY KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7225 N CALDWELL AVE, NILES, IL 60714-4548
(847) 647-0707
(847) 647-1402
Mailing address
7225 N CALDWELL AVE, NILES, IL 60714-4548
(847) 647-0707
(847) 647-1402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011274
IL
152WC0802X
Corneal and Contact Management Optometrist
046.011274
IL
Other
Enumeration date
07/06/2009
Last updated
05/18/2019
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