Individual
JEFFREY T MANTERNACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3333 W TOUHY AVE, LINCOLNWOOD TOWN CENTER, LINCOLNWOOD, IL 60712-2721
(847) 675-8637
Mailing address
1000 W LELAND AVE, APT 11D, CHICAGO, IL 60640-3064
(563) 543-7174
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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