Individual
DR. THERESE MARIE PORRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1410 S RANDALL RD, ALGONQUIN, IL 60102-5919
(847) 458-5796
Mailing address
620 ECHO TRL, MARENGO, IL 60152-8058
(708) 261-4902
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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