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General NPI Number Information
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NPI Number | 1508095357
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Entity Type | Organization
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Legal Business Name | MAXIVISION, PC
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 4931 S. ROUTE 59 SUITE # 115
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City | NAPERVILLE
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State | IL
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Zip | 60564-2692
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Country | US
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Telephone | 630-904-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 4931 S. ROUTE 59 SUITE # 115
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City | NAPERVILLE
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State | IL
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Zip | 60564-2692
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Country | US
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Telephone | 630-904-1900
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY
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Name | DR. PRASOD RAMACHANDRAN
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Credential |
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Telephone | 630-904-1900
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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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