Individual
TRICIA VALTERS DANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
510 N WESTERN AVE, LAKE FOREST, IL 60045-1920
(847) 283-0800
(847) 283-0782
Mailing address
510 N WESTERN AVE, LAKE FOREST, IL 60045-1920
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009791
IL
Other
Enumeration date
01/24/2006
Last updated
04/15/2010
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