Healthcare Provider Details

I. General information

NPI: 1740115203
Provider Name (Legal Business Name): APRIL SAYAVONG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12812 WESTERN AVE
BLUE ISLAND IL
60406-2118
US

IV. Provider business mailing address

7778 WOODWARD AVE
WOODRIDGE IL
60517-3109
US

V. Phone/Fax

Practice location:
  • Phone: 708-385-0013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: