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General NPI Number Information
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NPI Number | 1043026529
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Entity Type | Individual
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Provider Name | DUNCAN JOSEPH MCNEILLIE OD
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Gender | Male
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 329 W 18TH ST STE 311
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City | CHICAGO
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State | IL
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Zip | 60616-5132
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Country | US
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Telephone | 312-929-3340
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Fax |
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Provider Business Mailing Address
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Address Line | 450 W BELMONT AVE APT 1602
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City | CHICAGO
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State | IL
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Zip | 60657-7591
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Country | US
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Telephone | 281-757-7925
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 046.011940
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License Number State | IL
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