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General NPI Number Information
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NPI Number | 1003078577
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Entity Type | Organization
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Legal Business Name | CHANDER VISION GROUP LTD
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 5460 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-3033
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Country | US
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Telephone | 773-735-6090
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Fax | 773-581-0320
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Provider Business Mailing Address
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Address Line | 5460 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-3033
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Country | US
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Telephone | 773-735-6090
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Fax | 773-581-0320
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Authorized Official
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Title or Position | CLINICAL DIRECTOR OPTOMETRIST
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Name | DR. SANDIP STEVEN CHANDER
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Credential | O.D.
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Telephone | 773-735-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0468891
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License Number State | IL
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