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General NPI Number Information
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NPI Number | 1194977595
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Entity Type | Organization
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Legal Business Name | DR. ALAN E. KNOTEK, OPTOMETRIST
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 29 S WEBSTER ST SUITE 104
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City | NAPERVILLE
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State | IL
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Zip | 60540-5356
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Country | US
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Telephone | 630-357-6880
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Fax |
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Provider Business Mailing Address
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Address Line | 29 S WEBSTER ST SUITE 104
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City | NAPERVILLE
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State | IL
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Zip | 60540-5356
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Country | US
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Telephone | 630-357-6880
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN E. KNOTEK
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Credential | O.D.
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Telephone | 630-357-6880
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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 | 046006864
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License Number State | IL
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