Individual
JEFFNA ELAVUMKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
9916 75TH ST STE 101, KENOSHA, WI 53142-7583
(262) 658-1937
Mailing address
92 ASHLAND AVE, DES PLAINES, IL 60016-6118
(224) 703-0062
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4071-35
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2025
Last updated
07/22/2025
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