Individual
JESSICA CHASE ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, MPH, FAAO
Contact information
Practice address
2000 N NEIL ST, CHAMPAIGN, IL 61820-7808
(217) 356-8585
Mailing address
6036 S WILSON DR, CHANDLER, AZ 85249-4969
(304) 282-1753
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002555
AZ
Other
Enumeration date
02/28/2018
Last updated
07/11/2024
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