Organization
FOREMAN & STACK OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHERINE MARY STACK OD (OWNER OPTOMETRIST)
(630) 469-2418
Entity
Organization
Contact information
Practice address
876 ROOSEVELT RD, GLEN ELLYN, IL 60137
(630) 469-2418
(630) 469-4680
Mailing address
876 ROOSEVELT RD, GLEN ELLYN, IL 60137
(630) 469-2418
(630) 469-4680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046007738
IL
152W00000X
Optometrist
046007804
IA
152W00000X
Optometrist
Primary
046007804
IL
Other
Enumeration date
10/16/2007
Last updated
02/16/2011
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