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Individual

JULIE BRUCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3500 W PETERSON AVE, SUITE 401, CHICAGO, IL 60659-3306
(773) 588-3090
(773) 588-3210
Mailing address
3500 W PETERSON AVE, SUITE 401, CHICAGO, IL 60659-3306
(773) 588-3090
(773) 588-3210

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010027
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001604768
BLUE CROSS BLUE SHEILD
IL
05
046010027
IL
01
P01107047
RAILROAD MEDICARE
Enumeration date
10/18/2007
Last updated
07/09/2014
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