Organization
EYESITE-ILLINOIS VALLEY, LLC
Active
Other names
Illinois Valley Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
KENT ALAN KUNKEL OD (OWNER)
(815) 664-5331
Entity
Organization
Contact information
Practice address
215 RICHARD A MAUTINO DR, SPRING VALLEY, IL 61362-1144
(815) 664-5331
(815) 663-5057
Mailing address
215 RICHARD A MAUTINO DR, SPRING VALLEY, IL 61362-1144
(815) 664-5331
(815) 663-5057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008411
IL
Other
Enumeration date
12/13/2006
Last updated
12/15/2020
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