Individual
MR. TEODORO CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
4610 N LINCOLN AVE, CHICAGO, IL 60625-2008
(773) 561-0870
(773) 561-4185
Mailing address
4610 N LINCOLN AVE, CHICAGO, IL 60625-2008
(773) 561-0870
(773) 561-4185
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2511-5278
IL
Other
Enumeration date
03/21/2007
Last updated
02/12/2026
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