Individual
JERESS T PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-4201
(312) 949-7000
Mailing address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-4201
(312) 949-7000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011520
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/04/2021
Last updated
06/11/2021
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