Provider Demographics
NPI:1073523262
Name:TUEL, JAMES A (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:TUEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:24510 W LOCKPORT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2312
Mailing Address - Country:US
Mailing Address - Phone:815-254-2546
Mailing Address - Fax:815-254-2566
Practice Address - Street 1:24510 W LOCKPORT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2312
Practice Address - Country:US
Practice Address - Phone:815-254-2546
Practice Address - Fax:815-254-2566
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL046-008289152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932276OtherBCBS OF IL
ILU41352Medicare UPIN
IL208511Medicare ID - Type Unspecified