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Ernest I. Watanabe, O.d. Ltd.
Clinic/Center in Chicago, Illinois
NPI 1285818120

Ernest I. Watanabe, O.d. Ltd. is a Clinic/Center based in Chicago, IL. Ernest I. Watanabe, O.d. Ltd. practices in Chicago, IL. The NPI Number for Ernest I. Watanabe, O.d. Ltd. is 1285818120 and holds a License No. 046006692 (Illinois).

The current practice location address for Ernest I. Watanabe, O.d. Ltd. is 1108 W Granville Ave, Chicago, IL and can be reached out via phone at 773-465-6660 and via fax at 773-274-8222.

Location: 1108 W Granville Ave, Chicago, IL, 60660-2013
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1285818120
Provider Name
Ernest I. Watanabe, O.d. Ltd.
Credential
Provider Entity Type
Organization
Address
1108 W Granville Ave, Chicago, IL, 60660-2013
Phone Number
773-465-6660
Fax Number
773-274-8222
Provider Enumeration Date
12/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
046006692 01 IL IL STATE LICENSE
1053488569 01 INDIVIDUAL NPI #
institution
Provider Business Practice Location Address Details
Address
1108 W Granville Ave
City
Chicago
State
Illinois
Zip
60660-2013
Phone Number
773-465-6660
Fax Number
773-274-8222
person
Provider Business Mailing Address Details
Address
1108 W Granville Ave
City
Chicago
State
Illinois
Zip
60660-2013
Phone Number
773-465-6660
Fax Number
773-274-8222
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
046006692 (Illinois)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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