Individual
DR. CATHERINE M STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
876 ROOSEVELT RD, GLEN ELLYN, IL 60137
(630) 469-2418
(630) 469-4680
Mailing address
876 ROOSEVELT RD, GLEN ELLYN, IL 60137
(630) 469-2418
(630) 469-4680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007738
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083803050
GROUP NPI
—
Enumeration date
02/16/2007
Last updated
02/16/2011
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