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Organization

KMR SERVICES LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REGINO JOHN FLORA O.D. (PRESIDENT)
(815) 528-5140
Entity
Organization

Contact information

Practice address
4700 135TH ST, CRESTWOOD, IL 60445-1405
(708) 489-6951
(708) 589-8012
Mailing address
16400 PIONEER PKWY, LOCKPORT, IL 60441-4787
(815) 528-5140

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009047
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009047
IL
Enumeration date
06/06/2016
Last updated
06/06/2016
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