Provider Demographics
NPI:1871018036
Name:LE, HOLLY (OD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1333 BURR RIDGE PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0833
Mailing Address - Country:US
Mailing Address - Phone:630-756-3180
Mailing Address - Fax:630-608-4397
Practice Address - Street 1:1333 BURR RIDGE PKWY
Practice Address - Street 2:STE 200
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-0833
Practice Address - Country:US
Practice Address - Phone:630-756-3180
Practice Address - Fax:630-608-4397
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL046.011128152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist