Organization
CHITTICK FAMILY EYE CARE LTD
Active
Other names
Leon Optometric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN P MALLADY OD (PRESIDENT)
(508) 837-3790
Entity
Organization
Contact information
Practice address
1104 N VERMILION ST, DANVILLE, IL 61832-3094
(217) 398-2020
(217) 442-0119
Mailing address
1104 N VERMILION ST, DANVILLE, IL 61832-3094
(217) 398-2020
(217) 442-0119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
09/20/2006
Last updated
11/19/2024
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