Provider Demographics
NPI:1912124074
Name:WITT, IRENE M (OD)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:M
Last Name:WITT
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Gender:F
Credentials:OD
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Mailing Address - Street 1:618 S ROUTE 59
Mailing Address - Street 2:SUITE 118 (IDOCS OF NAPERVILLE INSIDE FOR EYES)
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0937
Mailing Address - Country:US
Mailing Address - Phone:630-355-1269
Mailing Address - Fax:630-355-1295
Practice Address - Street 1:618 S ROUTE 59
Practice Address - Street 2:SUITE 118 (IDOCS OF NAPERVILLE INSIDE FOR EYES)
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-0937
Practice Address - Country:US
Practice Address - Phone:630-355-1269
Practice Address - Fax:630-355-1295
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-05-12
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Provider Licenses
StateLicense IDTaxonomies
IL046007701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist