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General NPI Number Information
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NPI Number | 1548329089
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Entity Type | Organization
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Legal Business Name | KRISTEN LANGNER EYE CARE PC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 55 E MAIN ST
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City | ROSELLE
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State | IL
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Zip | 60172-2076
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Country | US
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Telephone | 630-529-0993
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Fax | 630-529-1220
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Provider Business Mailing Address
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Address Line | 55 E MAIN ST
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City | ROSELLE
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State | IL
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Zip | 60172-2076
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Country | US
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Telephone | 630-529-0993
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Fax | 630-529-1220
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTEN A LANGNER
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Credential | OD
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Telephone | 630-529-0993
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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 | 046008752
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License Number State | IL
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