Organization
CRYSTAL LAKE OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD SUROWIAK O.D. (PRESIDENT)
(815) 459-4074
Entity
Organization
Contact information
Practice address
6314 NORTHWEST HWY, CRYSTAL LAKE, IL 60014-7935
(815) 459-4074
(815) 459-4061
Mailing address
6314 NORTHWEST HWY, CRYSTAL LAKE, IL 60014-7935
(815) 459-4074
(815) 459-4061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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