Individual
VLADISLAV SOUBOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5115 152ND ST, OAK FOREST, IL 60452-2357
(708) 645-6030
Mailing address
5115 152ND ST, OAK FOREST, IL 60452-2357
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.012029
IL
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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