Palermo, Mario Lawrence

Palermo, Mario Lawrence is an individual health care provider with primary practice located at 18 S Evergreen Ave , Arlington Heights IL 60005-1428. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Palermo, Mario Lawrence can be contacted via phone (847) 253-8500.

Contact Information

Primary practice address
18 S Evergreen Ave Arlington Heights IL 60005-1428
Phone: (847) 253-8500
Fax: (847) 253-8538
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046007444 Illinois

Profile Details

NPI number 1104806348
LBN Legal business name Palermo, Mario Lawrence
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Jan 29th, 2010 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104806348 NPPES
Illinois Other 1684526 BLUE CROSS BLUE SHIELD

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