Provider Demographics
NPI:1770651036
Name:JUKES, RHEA (OD)
Entity Type:Individual
Prefix:
First Name:RHEA
Middle Name:
Last Name:JUKES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3140
Mailing Address - Country:US
Mailing Address - Phone:847-290-1131
Mailing Address - Fax:847-290-1146
Practice Address - Street 1:1131 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3140
Practice Address - Country:US
Practice Address - Phone:847-290-1131
Practice Address - Fax:847-290-1146
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU24828Medicare UPIN