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General NPI Number Information
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NPI Number | 1982982385
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Entity Type | Organization
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Legal Business Name | CLARENDON VISION DEVELOPMENT CENTER
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 700 E OGDEN AVE STE 200
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City | WESTMONT
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State | IL
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Zip | 60559-1296
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Country | US
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Telephone | 630-323-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E OGDEN AVE STE 200
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City | WESTMONT
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State | IL
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Zip | 60559-1296
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Country | US
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Telephone | 630-323-7300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MONIKA SPOKAS
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Credential | OD
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Telephone | 630-640-6769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 046009498
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License Number State | IL
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