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NPI Code Detail

MEDICARE: DR. MARY LOU FRENCH O.D.

MEDICARE: DR. MARY LOU FRENCH 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
1152WP0200XPediatric Optometrist46-6963IL
2152WV0400XVision Therapy Optometrist466963IL

General Provider Information

NPI Number : 1740263573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY LOU FRENCH O.D.
Provider Business Mailing Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Provider Business Practice Location Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 01/03/2017

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