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NPI Code Detail

MEDICARE: VICTORIA ALFAFARA O.D.

MEDICARE:   VICTORIA  ALFAFARA  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046-007839IL

General Provider Information

NPI Number : 1003093857
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ALFAFARA O.D.
Provider Business Mailing Address
First Line : 122 BROADVIEW VILLAGE SQ
Second Line :
City : BROADVIEW
State : IL
Zip : 60155-4874
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 122 BROADVIEW VILLAGE SQ
Second Line :
City : BROADVIEW
State : IL
Zip : 60155-4874
Country : US
Telephone Number : 708-343-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2008
Last Update Date : 01/05/2026

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Directions to “ VICTORIA ALFAFARA O.D.” Practice Location

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