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Organization

TWO NON-BLONDES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANITA HAN O.D. (OPTOMETRIST)
(224) 676-1022
Entity
Organization

Contact information

Practice address
2013 MILWAUKEE AVE, RIVERWOODS, IL 60015-3581
(224) 676-1022
Mailing address
2013 MILWAUKEE AVE, RIVERWOODS, IL 60015-3581
(224) 676-1022

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010088
IL
152W00000X
Optometrist
046.010749
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046.010088
IL
Enumeration date
03/22/2017
Last updated
06/23/2017
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