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Individual

MISS MICAELA TOLEDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
9400 S WESTERN AVE, EVERGREEN PARK, IL 60805-2509
(708) 636-5301
(708) 636-6518
Mailing address
8347 S 79TH CT, JUSTICE, IL 60458-2321

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010295
IL

Other

Enumeration date
04/15/2010
Last updated
04/15/2010
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