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Individual

DR. JOSHUA L KORSGARDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
472 N STATE ROUTE 47, SUITE E, SUGAR GROVE, IL 60554-8106
(630) 650-2041
Mailing address
139A GILLETT ST, SUGAR GROVE, IL 60554-9323
(630) 650-2041

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
047-930861
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
047-930861
IL
01
346-002120
CS LICENSE
IL
Enumeration date
06/04/2006
Last updated
03/07/2023
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