Individual
DR. CHULA LERDVORATAVEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2075 WIESBROOK RD, OSWEGO, IL 60543-8312
(630) 844-0908
(630) 844-0677
Mailing address
2075 WIESBROOK RD, OSWEGO, IL 60543-8312
(630) 844-0908
(630) 844-0677
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007841
IL
152WC0802X
Corneal and Contact Management Optometrist
046-007841
IL
152WL0500X
Low Vision Rehabilitation Optometrist
046-007841
IL
Other
Enumeration date
10/26/2005
Last updated
07/21/2022
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