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General NPI Number Information
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NPI Number | 1285873711
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Entity Type | Organization
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Legal Business Name | ANITA HAN OPTOMETRY, LLC
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 2013 MILWAUKEE AVE
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City | RIVERWOODS
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State | IL
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Zip | 60015-3581
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Country | US
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Telephone | 224-676-1022
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Fax | 224-676-2050
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Provider Business Mailing Address
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Address Line | 1101 S STATE ST UNIT 1402
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City | CHICAGO
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State | IL
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Zip | 60605-3175
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Country | US
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Telephone | 847-452-9188
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Fax | 847-537-4855
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANITA MI-YOUNG HAN
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Credential | O.D.
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Telephone | 224-676-1022
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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 | 046010088
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License Number State | IL
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