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General NPI Number Information
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NPI Number | 1437609054
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Entity Type | Organization
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Legal Business Name | DR. JERIES QTAMI & ASSOCIATES INC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 21000 WESTERN AVE
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1900
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Country | US
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Telephone | 708-898-9112
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Fax | 708-283-0609
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Provider Business Mailing Address
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Address Line | 47 W POLK ST STE 100-135
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City | CHICAGO
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State | IL
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Zip | 60605-2000
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Country | US
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Telephone | 708-898-9112
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Fax | 708-283-0609
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JERIES QTAMI
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Credential | O.D.
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Telephone | 708-898-9112
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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 | 046010554
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License Number State | IL
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