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NPI Code Detail

MEDICARE: LAUREN ALLEY RODOLFO O.D.

MEDICARE:   LAUREN ALLEY RODOLFO  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046-010264IL

General Provider Information

NPI Number : 1922306687
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ALLEY RODOLFO O.D.
Provider Business Mailing Address
First Line : 1131 S ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HTS
State : IL
Zip : 60005-3140
Country : US
Telephone Number : 847-290-1131
Fax Number : 847-290-1146
Provider Business Practice Location Address
First Line : 1131 S ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HTS
State : IL
Zip : 60005-3140
Country : US
Telephone Number : 847-290-1131
Fax Number : 847-290-1146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2011
Last Update Date : 03/04/2011

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Directions to “ LAUREN ALLEY RODOLFO O.D.” Practice Location

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