Organization
BUENA VISTA OPTICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD SIMS O.D. (PRESIDENT)
(773) 863-9234
Entity
Organization
Contact information
Practice address
6455 S KEDZIE AVE, CHICAGO, IL 60629-2829
(773) 863-9234
(773) 863-9274
Mailing address
6455 S KEDZIE AVE, CHICAGO, IL 60629-2829
(773) 863-9234
(773) 863-9274
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
046-009243
IL
332H00000X
Eyewear Supplier
046-009243
IL
Other
Enumeration date
12/19/2007
Last updated
09/11/2013
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