Organization
MATTHEW DEGROOT O.D. P.C.
Active
Other names
Envision Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ROGER DEGROOT O.D. (OWNER/PRESIDENT)
(312) 492-3615
Entity
Organization
Contact information
Practice address
1430 S ASHLAND AVE, CHICAGO, IL 60608-2040
(312) 492-3615
(312) 492-3614
Mailing address
622 ELMDALE RD, GLENVIEW, IL 60025-3902
(847) 452-7375
(312) 492-3615
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009580
IL
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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