Individual
DR. JEFFREY SCOTT PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1205 S IL ROUTE 31, CRYSTAL LAKE, IL 60014-8213
(815) 477-4053
(815) 477-4302
Mailing address
3912 VALLEY VIEW RD, CRYSTAL LAKE, IL 60012-2104
(847) 323-8501
(312) 781-3527
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.008991
IL
Other
Enumeration date
02/14/2007
Last updated
08/20/2020
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