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General NPI Number Information
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NPI Number | 1386800316
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Entity Type | Organization
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Legal Business Name | QUALITY EYE CARE CLINIC LTD
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 502 WAVERLY DRIVE
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City | ELGIN
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State | IL
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Zip | 60120-1392
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Country | US
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Telephone | 847-697-7771
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Fax | 847-393-8153
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Provider Business Mailing Address
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Address Line | 502 WAVERLY DR
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City | ELGIN
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State | IL
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Zip | 60120-4082
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Country | US
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Telephone | 708-692-6174
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANAL HAJALI
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Credential | OD
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Telephone | 708-692-6174
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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 | 046-009959
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License Number State | IL
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