Organization
LA VALLEE OPTOMETRIC LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH LA VALLEE O.D. (PRESIDENT)
(773) 895-3411
Entity
Organization
Contact information
Practice address
2111 W SUPERIOR ST, CHICAGO, IL 60612-1315
(773) 895-3411
(312) 226-0802
Mailing address
2111 W SUPERIOR ST, CHICAGO, IL 60612-1315
(773) 895-3411
(312) 226-0802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009075
IL
Other
Enumeration date
12/05/2006
Last updated
09/29/2008
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