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General NPI Number Information
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NPI Number | 1851024194
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Entity Type | Individual
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Provider Name | VIANNA LE HA OD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 62 OAKBROOK CTR
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City | OAK BROOK
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State | IL
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Zip | 60523-1810
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Country | US
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Telephone | 630-243-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 W 15TH ST APT 405-2
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City | CHICAGO
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State | IL
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Zip | 60608-2280
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Country | US
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Telephone | 312-810-0925
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Fax |
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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 | 046.011642
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License Number State | IL
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