Organization
THE EYEGLASS STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MINAS SPOURDALAKIS (PRESIDENT)
(708) 848-6640
Entity
Organization
Contact information
Practice address
715 LAKE ST STE 130, OAK PARK, IL 60301-1403
(708) 848-6640
(708) 848-6646
Mailing address
715 LAKE STREET, STE 130, OAK PARK, IL 60301-1422
(708) 848-6640
(708) 848-6646
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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