Individual
DR. TEHNEIYAT MACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
152 S BLOOMINGDALE RD, BLOOMINGDALE, IL 60108-1481
(630) 980-4446
(630) 980-2313
Mailing address
152 S BLOOMINGDALE RD, BLOOMINGDALE, IL 60108-1481
(630) 980-4446
(630) 980-2313
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010772
IL
152W00000X
Optometrist
046010772
IL
152WC0802X
Corneal and Contact Management Optometrist
046.010772
IL
152WP0200X
Pediatric Optometrist
046.010772
IL
Other
Enumeration date
06/08/2014
Last updated
01/27/2022
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