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General NPI Number Information
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NPI Number | 1801987367
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Entity Type | Organization
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Legal Business Name | ARSENEAU OPTICAL OF KANKAKEE INC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 135 W COURT ST
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City | KANKAKEE
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State | IL
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Zip | 60901
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Country | US
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Telephone | 815-933-5798
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Fax | 815-929-5760
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Provider Business Mailing Address
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Address Line | 135 W COURT ST
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City | KANKAKEE
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State | IL
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Zip | 60901
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Country | US
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Telephone | 815-933-5798
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Fax | 815-929-5760
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Authorized Official
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Title or Position | PRES OPTICIAN
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Name | MARY TROST
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Credential |
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Telephone | 815-933-5798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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