Search › Illinois › 152W00000X
Jay Black, OD
NPI 1629113261 · on the registry since 2007
Practice
- Address
- 5316 N Second Street
Loves Park, IL 61111 - Phone
- (815) 877-6551
- Fax
- (815) 877-4821
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois