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NPI 1477426807

NPI 1477426807 : ONEOPTO IL 2 PLLC : FAIRVIEW HEIGHTS, IL

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General NPI Number Information
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    NPI Number           |    1477426807
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    Entity Type          |    Organization 
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    Legal Business Name  |    ONEOPTO IL 2 PLLC 
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Dates
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    Enumeration Date     |    09/23/2025
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    Last Update Date     |    09/23/2025
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Provider Practice Location Address
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    Address Line         |    10900 LINCOLN TRL STE A 
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    City                 |    FAIRVIEW HEIGHTS
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    State                |    IL
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    Zip                  |    62208-2042
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    Country              |    US
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    Telephone            |    618-234-2020
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    Fax                  |    618-234-2022
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Provider Business Mailing Address
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    Address Line         |    10900 LINCOLN TRL STE A 
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    City                 |    FAIRVIEW HEIGHTS
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    State                |    IL
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    Zip                  |    62208-2042
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    Country              |    US
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    Telephone            |    618-234-2020
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    Fax                  |    618-234-2022
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     PRISCILLA  PAPPAS 
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    Credential           |    
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    Telephone            |    217-877-7900
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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       |    
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    License Number State |    
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