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Organization

LAVENDER STREIFF PC

Active
Other names
Bensenville Eye Care
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAVENDER STREIFF O.D. (PRESIDENT/VICE PRESIDENT/SECRETARY)
(847) 254-9665
Entity
Organization

Contact information

Practice address
117 W MAIN ST, BENSENVILLE, IL 60106-2133
(630) 860-5066
Mailing address
117 W MAIN ST, BENSENVILLE, IL 60106-2133
(630) 860-5066

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009684
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009684
IL
01
1634550
BLUE CROSS BLUE SHIELD
IL
01
DN7492
RAILROAD MEDICARE
IL
Enumeration date
09/25/2007
Last updated
04/23/2009
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