Provider Demographics
NPI:1306366232
Name:TILL, CHELSEA (OD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:TILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:MCGLOTHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:9745 FALL CREEK RD STE 400
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4730
Practice Address - Country:US
Practice Address - Phone:317-578-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004038A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist