Organization
SUBURBAN OPTOMETRIC GROUP, P.C.
Active
Parent organization
SUBURBAN OPTOMETRIC GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUBURBAN OPTOMETRIC GROUP
Authorized official
MAGGIE M ZAHARA (MANAGER)
(708) 349-2600
Entity
Organization
Contact information
Practice address
10001 W 143RD ST, ORLAND PARK, IL 60462-2026
(708) 349-2600
Mailing address
10001 W 143RD ST, ORLAND PARK, IL 60462-2026
(708) 349-2600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
060.007985
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA8522
RR MEDICARE GROUP
IL
Enumeration date
01/30/2007
Last updated
05/20/2008
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