Healthcare Provider Details

I. General information

NPI: 1437522141
Provider Name (Legal Business Name): VISION PARTNER LABS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 01/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W GRAND AVE STE 130
ELMHURST IL
60126-1061
US

IV. Provider business mailing address

655 W GRAND AVE STE 130
ELMHURST IL
60126-1061
US

V. Phone/Fax

Practice location:
  • Phone: 708-657-2388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER ALLEN
Title or Position: PRIVACY OFFICER
Credential:
Phone: 801-316-5508