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Individual

PAUL A FOREMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6601 N AVONDALE AVE, SUITE 102, CHICAGO, IL 60631-1572
(773) 792-1011
(773) 889-0224
Mailing address
6601 N AVONDALE AVE, SUITE 102, CHICAGO, IL 60631-1572
(773) 792-1011
(773) 889-0224

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1622243
BCBS IL GROUP
IL
Enumeration date
03/16/2006
Last updated
10/01/2007
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