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Organization

ILLINOIS VALLEY EYE INST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LIBBY K KRISTAL MD (OWNER)
(815) 434-4200
Entity
Organization

Contact information

Practice address
818 LASALLE ST, OTTAWA, IL 61350
(815) 434-4200
(815) 434-2033
Mailing address
818 LASALLE ST, OTTAWA, IL 61350
(815) 434-4200
(815) 434-2033

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
IL

Other

Enumeration date
12/01/2005
Last updated
08/22/2020
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