Healthcare Provider Details
I. General information
NPI: 1508174947
Provider Name (Legal Business Name): KUHAR VISION CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
932 BROOK FOREST AVE
SHOREWOOD IL
60404-8807
US
IV. Provider business mailing address
932 BROOK FOREST AVE
SHOREWOOD IL
60404-8807
US
V. Phone/Fax
- Phone: 815-577-0020
- Fax: 815-577-3884
- Phone: 815-577-0020
- Fax: 815-577-3884
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 046-009027 |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
LUDWIG
C
KUHAR
Title or Position: PRESIDENT/OPTOMETRIST
Credential: O.D.
Phone: 815-577-0020