Organization
EYESITE-ILLINOIS VALLEY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT KUNKEL O.D. (OWNER)
(815) 434-7970
Entity
Organization
Contact information
Practice address
925 CLINTON ST, OTTAWA, IL 61350-2037
(815) 434-7970
(815) 434-7950
Mailing address
925 CLINTON ST, OTTAWA, IL 61350-2037
(815) 434-7970
(815) 434-7950
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46-008411
IL
Other
Enumeration date
02/09/2007
Last updated
01/20/2021
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