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General NPI Number Information
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NPI Number | 1215289558
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Entity Type | Organization
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Legal Business Name | PAULA S. MINTCHELL,O.D., P.C.
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 1995 SPRINGBROOK SQUARE DR SUITE111
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City | NAPERVILLE
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State | IL
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Zip | 60564-5951
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Country | US
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Telephone | 630-961-0300
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Fax | 630-961-0301
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Provider Business Mailing Address
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Address Line | 1995 SPRINGBROOK SQUARE DR SUITE111
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City | NAPERVILLE
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State | IL
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Zip | 60564-5951
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Country | US
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Telephone | 630-961-0300
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Fax | 630-961-0301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAULA S. MINTCHELL
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Credential | OD
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Telephone | 630-961-0300
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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 | 46-009355
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License Number State | IL
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