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General NPI Number Information
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NPI Number | 1871206706
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Entity Type | Organization
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Legal Business Name | FAMILY EYECARE ALEXIS E SCATCHELL OD
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 5316 N MILWAUKEE AVE # 2C
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City | CHICAGO
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State | IL
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Zip | 60630-1269
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Country | US
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Telephone | 708-831-4564
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Fax | 708-831-4567
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Provider Business Mailing Address
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Address Line | 5316 N MILWAUKEE AVE # 2C
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City | CHICAGO
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State | IL
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Zip | 60630-1269
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Country | US
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Telephone | 708-831-4564
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Fax | 708-831-4567
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ALEXANDRIA E SCATCHELL
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Credential |
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Telephone | 773-458-3230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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