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General NPI Number Information
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NPI Number | 1073849931
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Entity Type | Organization
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Legal Business Name | RUCNOK VISION CARE INC
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 333 E US ROUTE 6
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City | MORRIS
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State | IL
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Zip | 60450-8920
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Country | US
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Telephone | 815-942-5918
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Fax | 815-942-4794
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Provider Business Mailing Address
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Address Line | 5021 ESSINGTON LN
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60010-5522
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Country | US
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Telephone | 815-942-5918
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Fax | 815-942-4794
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN T. GIANNONE
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Credential | OD
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Telephone | 815-942-5918
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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 | 046006846
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License Number State | IL
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