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Organization

JONATHAN L OTTINO, O.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN L OTTINO O.D. (CEO)
(224) 558-6357
Entity
Organization

Contact information

Practice address
1100 LEJUNE DR, SPRINGFIELD, IL 62703-4537
(224) 558-6357
Mailing address
3617 N GRAND AVE E TRLR 259, SPRINGFIELD, IL 62702-8505

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009536
IL

Other

Enumeration date
08/27/2009
Last updated
08/27/2009
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