Individual
DR. MICHAEL WILLIAM MENCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1112 E RAILROAD ST, STE 1, SANDWICH, IL 60548-1894
(815) 786-2020
(815) 786-6306
Mailing address
1112 E RAILROAD ST, STE 1, SANDWICH, IL 60548-1894
(815) 786-2020
(815) 786-6306
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010227
IL
Other
Enumeration date
06/29/2009
Last updated
05/31/2011
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