MEDICARE: DENNIS DELEE OD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	46-006526	IL

General Provider Information

NPI Number	:	1659497071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS DELEE OD PLLC

Provider Business Mailing Address
First Line	:	209 S LA SALLE ST LBBY 120
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60604-1436
Country	:	US
Telephone Number	:	312-332-4461
Fax Number	:	312-332-5970

Provider Business Practice Location Address
First Line	:	209 S LA SALLE ST
Second Line	:	STE 120
City	:	CHICAGO
State	:	IL
Zip	:	60604-1219
Country	:	US
Telephone Number	:	312-332-4461
Fax Number	:	312-332-5970

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT POUYAT
Credential	:
Telephone Number	:	847-395-8885

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	02/04/2026

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