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General NPI Number Information
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NPI Number | 1730256470
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Entity Type | Individual
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Provider Name | PETER JAY EPSTEIN OD.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 335 N MILWAUKEE AVE
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City | VERNON HILLS
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State | IL
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Zip | 60061-1561
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Country | US
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Telephone | 847-955-9280
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Fax | 847-955-9282
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Provider Business Mailing Address
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Address Line | 5248 RFD
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City | LONG GROVE
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State | IL
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Zip | 60047-7353
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Country | US
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Telephone | 847-521-0771
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Fax | 847-955-9282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 046-006615
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License Number State | IL
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