Individual
MARISSA ALDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3500 W PETERSON AVE STE 401, CHICAGO, IL 60659-3307
(773) 588-3090
Mailing address
PO BOX 207261, DALLAS, TX 75320-7261
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046011389
IL
152W00000X
Optometrist
091381
IA
152W00000X
Optometrist
Primary
2687
NC
152W00000X
Optometrist
3447ATI
OR
152W00000X
Optometrist
8539T
TX
152W00000X
Optometrist
OD60293969
WA
Other
Enumeration date
10/19/2009
Last updated
06/21/2022
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