Individual
JULIE K KUEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1870 W MAIN ST, SALEM, IL 62881-5838
(618) 548-6590
Mailing address
11901 WESTWOOD LN, HIGHLAND, IL 62249-3863
(618) 654-1704
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009624
IL
152W00000X
Optometrist
OPC3628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009624
—
IL
Enumeration date
06/23/2006
Last updated
09/16/2008
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