Organization
SCOTT B. FORD, LTD
Active
Other names
Scott B. Ford, LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT B FORD (PRESIDENT)
(847) 772-1904
Entity
Organization
Contact information
Practice address
5630 W TOUHY AVE, NILES, IL 60714-4001
(847) 647-8970
Mailing address
PO BOX 563, SKOKIE, IL 60076-0563
(847) 772-1904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720194830
—
IL
Enumeration date
07/19/2018
Last updated
07/19/2018
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