Individual
BREANNA KAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13327 IL-59 N, SUITE 111, PLAINFIELD, IL 60585
(406) 253-1087
Mailing address
5321 LANE PL UNIT 1, DOWNERS GROVE, IL 60515-4892
(406) 253-1087
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011576
IL
152W00000X
Optometrist
OPT-OPT-LIC-3894
MT
Other
Enumeration date
06/19/2020
Last updated
04/05/2022
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