Individual
TAYLER ANN GREENAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3402 W 111TH ST, CHICAGO, IL 60655-3339
(773) 941-6519
Mailing address
3402 W 111TH ST, CHICAGO, IL 60655-3339
(773) 941-6519
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011907
IL
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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