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General NPI Number Information
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NPI Number | 1780633347
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Entity Type | Individual
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Provider Name | EVANGELOS VATIANOU O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1000 RANDALL RD STE 100
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City | GENEVA
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State | IL
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Zip | 60134-2591
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Country | US
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Telephone | 630-232-1282
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Fax | 630-232-7011
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Provider Business Mailing Address
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Address Line | 2003 MONTGOMERY RD SUITE 104
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City | AURORA
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State | IL
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Zip | 60504-9078
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Country | US
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Telephone | 630-892-1401
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Fax | 630-892-1404
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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 | 046009329
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License Number State | IL
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