Individual
DAYRA MELISSA MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
14702 CICERO AVE, MIDLOTHIAN, IL 60445-3173
(608) 687-2115
Mailing address
50 E 16TH ST UNIT 1405, CHICAGO, IL 60616-5146
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011794
IL
Other
Enumeration date
09/14/2023
Last updated
09/17/2023
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