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Individual

DR. DENNIS J ELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3454 BROADWAY ST, MOUNT VERNON, IL 62864-2277
(618) 242-1090
(618) 242-1090
Mailing address
3454 BROADWAY ST, MOUNT VERNON, IL 62864-2277
(618) 242-1090
(618) 242-1090

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0046007091
IL
152W00000X
Optometrist
1619035
WI
152W00000X
Optometrist
T02348
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04600791
IL
Enumeration date
02/13/2006
Last updated
06/09/2008
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