Search › Illinois › 152W00000X
Travis Park, O.D
NPI 1689830275 · on the registry since 2008 · sole proprietor
Practice
- Address
- 1756 W Division St
Chicago, IL 60622 - Phone
- (773) 489-4848
- Fax
- (773) 489-0808
- Organisation at this address
- Division Optical Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- CA, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-04-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois