Individual
DR. LOUIS RAYMOND A JISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., O.D.
Contact information
Practice address
3800 HIGHLAND AVE, DOWNERS GROVE, IL 60515-1557
(630) 960-0456
Mailing address
3800 HIGHLAND AVE, DOWNERS GROVE, IL 60515-1557
(630) 960-0456
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010114
IL
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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