Organization
OCULAR DIAGNOSTICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HARRY FOURNIER MD (PRESIDENT)
(773) 774-2102
Entity
Organization
Contact information
Practice address
5201 N HARLEM AVE, CHICAGO, IL 60656-1803
(773) 774-2102
(773) 774-3581
Mailing address
5201 N HARLEM AVE, CHICAGO, IL 60656-1803
(773) 774-2102
(773) 774-3581
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21604189
BCBS PROVIDER NO
IL
Enumeration date
05/15/2008
Last updated
05/15/2008
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