Healthcare Provider Details
I. General information
NPI: 1477618197
Provider Name (Legal Business Name): GAIL JOYCE MAY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/22/2006
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1516 LEGACY CIR UNIT 102
NAPERVILLE IL
60563-1269
US
IV. Provider business mailing address
16642 WINDSOR CT
LEMONT IL
60439-4636
US
V. Phone/Fax
- Phone: 630-245-2020
- Fax: 630-245-2021
- Phone: 630-243-0504
- Fax: 630-355-9796
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | 046008621 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: