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General NPI Number Information
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NPI Number | 1861129108
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Entity Type | Individual
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Provider Name | LAURA CALMA OD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 2934 FINLEY RD
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1042
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Country | US
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Telephone | 477-091-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 5146 W PATTERSON AVE # 1E
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City | CHICAGO
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State | IL
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Zip | 60641-3415
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Country | US
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Telephone | 773-979-7917
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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 | OPC6088
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046.011670
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License Number State | IL
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