Licup, Albert Simon
Licup, Albert Simon is an individual health care provider with primary practice located at 603 Madison St , Oak Park IL 60302-4437. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Licup, Albert Simon can be contacted via phone (708) 383-2150.Contact Information
Primary practice address
603 Madison St
Oak Park IL 60302-4437
Phone: (708) 383-2150
Fax: (708) 383-2253
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046.009863 | Illinois |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3056-035 | Wisconsin |
Profile Details
| NPI number | 1720011125 |
|---|---|
| LBN Legal business name | Licup, Albert Simon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2006 |
| Last updated | May 28th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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