Individual
JAISON PANICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2300 US HIGHWAY 34, OSWEGO, IL 60543-7132
(630) 554-5927
Mailing address
2300 US HIGHWAY 34, OSWEGO, IL 60543-7132
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010581
IL
Other
Enumeration date
07/17/2012
Last updated
03/14/2018
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