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Organization

GUSTAFSON EYE CARE CLINICS, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS EARL GUSTAFSON O.D. (PRESIDENT)
(847) 638-7308
Entity
Organization

Contact information

Practice address
96 W NORTHWEST HWY, PALATINE, IL 60067-3571
(847) 358-7722
(847) 520-3280
Mailing address
96 W NORTHWEST HWY, PALATINE, IL 60067-3571
(847) 358-7722
(847) 520-3280

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008241
IL
332H00000X
Eyewear Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8241
IL
Enumeration date
05/30/2007
Last updated
03/13/2020
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