Individual
DR. THOMAS KENNETH BIALECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1350 N GALENA AVE, DIXON, IL 61021
(815) 284-3935
(815) 284-6094
Mailing address
4 TERRACE DR, OREGON, IL 61061-1237
(815) 732-6966
(815) 732-7613
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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