Organization
VON HOLTEN EYECARE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN LYNN VON HOLTEN O.D. (PRESIDENT/OPTOMETRIST)
(815) 922-3545
Entity
Organization
Contact information
Practice address
25824 W EAMES ST, CHANNAHON, IL 60410-5313
(815) 521-9950
Mailing address
24541 S BLACKHAWK DR, CHANNAHON, IL 60410-9303
(815) 922-3545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213926
PTAN
IL
Enumeration date
07/26/2006
Last updated
12/12/2013
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