Individual
DR. CHARLOTTE FLORENCE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1120 E WASHINGTON ST, GRAYSLAKE, IL 60030-7960
(847) 223-2000
(847) 223-9400
Mailing address
1120 E WASHINGTON ST, GRAYSLAKE, IL 60030-7960
(847) 223-2000
(847) 223-9400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008590
—
IL
01
—
1033303169
CORPORATE NPI
IL
Enumeration date
10/21/2005
Last updated
06/13/2008
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