Individual
JULLIAN CERASUOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1123 N STATE ST, CHICAGO, IL 60610-2717
(312) 878-2028
Mailing address
1140 N WELLS ST UNIT 604, CHICAGO, IL 60610-3068
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011300
IL
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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