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NPI Code Detail

MEDICARE: EYE BOUTIQUE, LLC

MEDICARE: EYE BOUTIQUE, LLC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1851549638
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE BOUTIQUE, LLC
Provider Business Mailing Address
First Line : 16800 W CLEVELAND AVE
Second Line :
City : NEW BERLIN
State : WI
Zip : 53151-3533
Country : US
Telephone Number : 262-432-2005
Fax Number : 262-432-2006
Provider Business Practice Location Address
First Line : 1622 COMMONS DRIVE
Second Line :
City : GENEVA
State : IL
Zip : 60134
Country : US
Telephone Number : 630-232-8798
Fax Number : 262-923-7674
Authorized Official
Title or Position : PRESIDENT
Name : MR. DARREN THOMAS HORNDASCH
Credential :
Telephone Number : 262-432-2005
Provider Enumeration Date : 09/04/2008
Last Update Date : 03/02/2026

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Directions to “EYE BOUTIQUE, LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.