Organization
MOBILE VISION OF ILLINOIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL JOSEPH FORZLEY O.D. (OWNER/OPTOMETRIST)
(630) 269-8518
Entity
Organization
Contact information
Practice address
1192 WALTER ST, LEMONT, IL 60439-2903
(630) 269-8518
Mailing address
1192 WALTER ST, LEMONT, IL 60439-2903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008265
IL
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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