OrganizationActive
Aeg Kentucky Professional, PLLC
NPI 1467214080 · Optometrist · Alton, IL
Provider details
- NPI number
- 1467214080
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Benjamin Chudner, Owner(314) 741-8183
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
111 E 4th St Ste 440
Alton, IL 62002-6206
Phone: (618) 462-9818
Fax: (314) 741-4947
Approximate (ZIP-level) locationGet directions
Mailing address
111 E 4th St Ste 440
Alton, IL 62002-6206
Registry dates
- Enumerated
- 2024-01-29
- Last updated
- 2024-06-20
- Certified
- 2024-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.