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General NPI Number Information
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NPI Number | 1831216951
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Entity Type | Organization
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Legal Business Name | T&K O.D., LTD
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 SPRINGFIELD AVE
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City | JOLIET
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State | IL
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Zip | 60435-6590
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Country | US
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Telephone | 815-744-3222
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Fax | 815-744-3519
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Provider Business Mailing Address
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Address Line | 301 SPRINGFIELD AVE
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City | JOLIET
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State | IL
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Zip | 60435-6590
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Country | US
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Telephone | 815-744-3222
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Fax | 815-744-3519
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Authorized Official
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Title or Position | PRESIDENT OPTOMETRIST
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Name | DR. TAUSEEF U TAHIR
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Credential | OD
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Telephone | 815-744-3222
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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 | IL
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