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General NPI Number Information
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NPI Number | 1306338330
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Entity Type | Organization
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Legal Business Name | EFP EYEWEAR, INC.
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1205 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60610-2213
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Country | US
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Telephone | 312-943-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60610-2213
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Country | US
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Telephone | 312-943-2020
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST, PRESIDENT
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Name | DR. LINDSAY LUKER
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Credential | OD
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Telephone | 312-943-2020
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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 | 046009758
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License Number State | IL
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