Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ALBERT SIMON LICUP, O.D.

Active

DR. ALBERT SIMON LICUP, O.D. is a Optometrist healthcare provider located in OAK PARK, Illinois. NPI 1720011125 is currently active in the NPPES registry. Verify at CMS.

Optometrist · OAK PARK, IL

Registration Details

NPI Number: 1720011125
Provider Type: Individual
Gender: Male
NPI Issued: Jul 9, 2006 (20.115106766101 yrs)
Last Updated: May 28, 2009
Licenses: 046.009863 (IL)

3056-035 (WI)

Practice Information

Address: 603 MADISON ST

OAK PARK, IL, 603024437
Browse IL providers · Browse ZIP 60302
Phone: 7083832150
Fax: 7083832253
Primary Specialty: Optometrist
152W00000X
Additional Specialty: Optometrist

Other Optometrist Providers in OAK PARK, IL

Name	Credential	NPI
ALEX R TAN	OD	1215921655
DR. MICHAEL JAMES BOWKER	OD	1164418273
DR. RAMSEY TANAKATSUBO	OD	1013940667
MS. ANA MILENA SURY	O.D	1144313313
MR. BARRY STEVEN BLATTBERG	OD	1083734206
DR. JAMIE H HAHM	O.D.	1598928020

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.