Organization
GLEN ELLYN VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN J SIKORSKI OD (PRESIDENT)
(630) 469-4141
Entity
Organization
Contact information
Practice address
440 N MAIN ST, GLEN ELLYN, IL 60137-5124
(630) 469-4141
(630) 469-2015
Mailing address
440 N MAIN ST, GLEN ELLYN, IL 60137-5124
(630) 469-4141
(630) 469-2015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.006197
IL
152WC0802X
Corneal and Contact Management Optometrist
046.006197
IL
152WP0200X
Pediatric Optometrist
046.006197
IL
152WV0400X
Vision Therapy Optometrist
046.006197
IL
Other
Enumeration date
12/19/2006
Last updated
05/18/2010
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