Organization
ILLINI EYECARE INC-CHAMPAIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ALICE SANDERS OD (OPTOMETRIST)
(217) 351-6110
Entity
Organization
Contact information
Practice address
518 E GREEN ST, CHAMPAIGN, IL 61820-5720
(217) 351-6110
(217) 351-6395
Mailing address
518 E GREEN ST, CHAMPAIGN, IL 61820-5720
(217) 351-6110
(217) 351-6395
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009770
IL
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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