Individual
DR. BRUCE M. PORTNOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1133 MCHENRY RD, ST.108, BUFFALO GROVE, IL 60089-1369
(847) 478-9091
(847) 478-9095
Mailing address
1432 GREGORY CT, INDIAN CREEK, IL 60061-3229
(847) 680-1674
(847) 478-9095
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46-006563
IL
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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