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:
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Health care specialties

SpecialtyCodeLicense #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 15 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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