Organization
LAKE OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS LEWINSON O.D. (OPTOMETRIST/OWNER)
(847) 587-0901
Entity
Organization
Contact information
Practice address
2 W GRAND AVE, SUITE107, FOX LAKE, IL 60020-1262
(847) 587-0901
(847) 587-8157
Mailing address
2 W GRAND AVE, SUITE107, FOX LAKE, IL 60020-1262
(847) 587-0901
(847) 587-8157
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007480
IL
Other
Enumeration date
08/10/2006
Last updated
07/20/2010
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