Individual
MITCHELL WILLIAM KANELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3450 LACEY RD, DOWNERS GROVE, IL 60515-5430
(630) 743-4500
(630) 743-4500
Mailing address
3450 LACEY RD, DOWNERS GROVE, IL 60515-5430
(630) 743-4500
(630) 743-4500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011732
IL
Other
Enumeration date
11/30/2022
Last updated
03/01/2024
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