Stack, Catherine M

Stack, Catherine M is an sole proprietor health care provider with primary practice located at 876 Roosevelt Rd , Glen Ellyn IL 60137. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Stack, Catherine M can be contacted via phone (630) 469-2418.

Contact Information

Primary practice address
876 Roosevelt Rd Glen Ellyn IL 60137
Fax: (630) 469-4680
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046007738 Illinois

Profile Details

NPI number 1578607156
LBN Legal business name Stack, Catherine M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 16th, 2007
Last updated Feb 16th, 2011 - about 13 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 1578607156 NPPES
Other 1083803050 GROUP NPI

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