Organization
LEON OPTOMETRIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE ALAN LEON OD (OPTOMETRIST)
(217) 832-2111
Entity
Organization
Contact information
Practice address
10 W ADAMS AVE # 200, VILLA GROVE, IL 61956-1513
(217) 832-2111
(217) 832-9935
Mailing address
10 W ADAMS AVE, VILLA GROVE, IL 61956-1513
(217) 832-2111
(217) 832-9935
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007325
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6195601
—
IL
Enumeration date
07/30/2008
Last updated
07/30/2008
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