Individual
DR. MARK VIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
135 W RIVER ST, BOURBONNAIS, IL 60914-1964
(815) 939-2222
(815) 939-0970
Mailing address
101 TERRACE CT, BOURBONNAIS, IL 60914-0806
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
046007828
IL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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