Individual
AMANDA SOUKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
120 E COUNTRYSIDE PKWY STE B, YORKVILLE, IL 60560-1878
(630) 553-6166
Mailing address
120 E COUNTRYSIDE PKWY STE B, YORKVILLE, IL 60560-1878
(630) 553-6166
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011904
IL
Other
Enumeration date
08/09/2024
Last updated
08/26/2024
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