Individual
DALE J SWETLISHNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Mailing address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008093
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008093
—
IL
Enumeration date
04/07/2006
Last updated
12/24/2024
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