NPI 1467214080

Aeg Kentucky Professional, PLLC

Organisation Optometrist Alton, IL

Practice location

Address: 111 E 4th St STE 440, Alton, IL 62002-6206
Phone: (618) 462-9818
Fax: (314) 741-4947

Authorised official

Name: Benjamin Chudner
Title: Owner
Phone: (314) 741-8183

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X

Other Optometrist providers in Illinois →

Registry record

NPI: 1467214080
Entity type: Organization
NPI issued: 29 Jan 2024
Record last updated: 20 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.