Organization
LINCOLN PARK EYES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERIC A BANSER OD (PRESIDENT)
(773) 525-8700
Entity
Organization
Contact information
Practice address
2842 N SHERIDAN RD, CHICAGO, IL 60657
(773) 525-8700
(773) 525-8699
Mailing address
2842 N SHERIDAN RD, CHICAGO, IL 60657
(773) 525-8700
(773) 525-8699
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03695646
IL
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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