Organization
DRS. PETERSON & JANNOTTA OPTOMETRISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL JOSEPH JANNOTTA OD (OWNER PRACTIONER)
(815) 385-7930
Entity
Organization
Contact information
Practice address
4306 W CRYSTAL LAKE RD, STE D, MCHENRY, IL 60050-4249
(815) 385-7930
(815) 385-9234
Mailing address
4306 W CRYSTAL LAKE RD, STE D, MCHENRY, IL 60050-4249
(815) 385-7930
(815) 385-9234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632150
GROUP BC BS
IL
Enumeration date
06/20/2007
Last updated
01/17/2008
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