Organization
JEFFREY DANNATT LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DANNATT OD (OPTOMETRIST)
(815) 282-3468
Entity
Organization
Contact information
Practice address
5020 N 2ND ST, LOVES PARK, IL 61111-5809
(815) 282-3468
Mailing address
5020 N 2ND ST, LOVES PARK, IL 61111-5809
(815) 282-3468
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008969
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008969
—
IL
Enumeration date
03/25/2016
Last updated
03/25/2016
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