Individual
FAYE THERESE GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1745 ORCHARD LN, NORTHFIELD, IL 60093-3432
(847) 787-1187
(847) 789-7181
Mailing address
1745 ORCHARD LN, NORTHFIELD, IL 60093-3432
(847) 787-1187
(847) 789-7181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010799
IL
Other
Enumeration date
06/30/2014
Last updated
08/01/2019
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