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Yuri Kisilevich
Optician in Lake Forest, Illinois
NPI 1639346158

Yuri Kisilevich is a Optician based in Lake Forest, IL and is specialized in Optician. Yuri Kisilevich practices in Lake Forest, IL. The NPI Number for Yuri Kisilevich is 1639346158 and holds a License No. (Illinois).

The current practice location address for Yuri Kisilevich is 654 N Bank Ln, Lake Forest, IL and can be reached out via phone at 847-234-6541.

Location: 654 N Bank Ln, Lake Forest, IL, 60045
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639346158
Provider Name
Yuri Kisilevich
Credential
Provider Entity Type
Individual
Gender
Male
Address
654 N Bank Ln, Lake Forest, IL, 60045
Phone Number
847-234-6541
Fax Number
Provider Enumeration Date
05/14/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
654 N Bank Ln
City
Lake Forest
State
Illinois
Zip
60045-1811
Phone Number
847-234-6541
Fax Number
person
Provider Business Mailing Address Details
Address
654 N Bank Ln
City
Lake Forest
State
Illinois
Zip
60045-1811
Phone Number
847-234-6541
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
()
Definition
Definition to come...
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