Individual
YURI KISILEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
654 N BANK LN, LAKE FOREST, IL 60045-1811
(847) 234-6541
Mailing address
654 BANK LANE, LAKE FOREST, IL 60045
(847) 234-6541
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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