Organization
FAHY AND FAHY OPTOMETRIST, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY FAHY O.D. (PRESIDENT)
(773) 685-0363
Entity
Organization
Contact information
Practice address
5943 W MONTROSE AVE, CHICAGO, IL 60634-1629
(773) 685-0364
(773) 668-0944
Mailing address
5943 W MONTROSE AVE, CHICAGO, IL 60634-1629
(773) 685-0364
(773) 668-0944
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
046007793
IL
152WV0400X
Vision Therapy Optometrist
—
—
Other
Enumeration date
04/13/2007
Last updated
07/05/2012
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