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Individual

ERIC A. AHLVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
982 JAMES ST, GALENA, IL 61036-1358
(815) 777-2566
(815) 777-0116
Mailing address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4100
(563) 584-4110

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-006510
IL
152W00000X
Optometrist
2650-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046006510
IL
Enumeration date
05/09/2006
Last updated
09/01/2010
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