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Individual

DR. GLORIA JEAN DOCHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
15410 S HARLEM AVE, ORLAND PARK, IL 60462-4333
(708) 633-0060
(708) 633-0077
Mailing address
6504 CHARLESTON ST, OAK FOREST, IL 60452-2623
(708) 687-2522

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040018663
BCBS
IL
01
0920080001
MEDICARE DME
IL
Enumeration date
10/16/2006
Last updated
02/25/2008
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