Individual
ANTHONY J GARREFFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7417 MADISON ST, FOREST PARK, IL 60130-1502
(708) 366-2020
(708) 366-3265
Mailing address
7417 MADISON ST, FOREST PARK, IL 60130-1502
(708) 366-2020
(708) 366-3265
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007331
IL
152W00000X
Optometrist
2318
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046007331
ILLINOIS MEDICAID NUMBER
IL
Enumeration date
01/18/2007
Last updated
03/04/2009
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