Organization
COMPLETE FAMILY EYECARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHASE A RUDOLPH O.D. (PRESIDENT)
(618) 942-5465
Entity
Organization
Contact information
Practice address
3121 S PARK AVE, HERRIN, IL 62948-3785
(618) 942-5465
(618) 942-7042
Mailing address
2813 S PARK AVE, HERRIN, IL 62948-3700
(618) 942-5465
(618) 942-7042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010332
IL
Other
Enumeration date
08/15/2010
Last updated
07/25/2019
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