John, Kerry M
John, Kerry M is an individual health care provider with primary practice located at 715 W Hillgrove Ave , La Grange IL 60525-5964. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. John, Kerry M can be contacted via phone (708) 482-3200.Contact Information
Primary practice address
715 W Hillgrove Ave
La Grange IL 60525-5964
Phone: (708) 482-3200
Fax: (708) 482-3288
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 046009289 | Illinois |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046009289 | Illinois |
Profile Details
| NPI number | 1891788212 |
|---|---|
| LBN Legal business name | John, Kerry M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Dec 13th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891788212 | NPPES |
| Illinois | MEDICAID | 046009289 |
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