Healthcare Provider Details
I. General information
NPI: 1124950522
Provider Name (Legal Business Name): WELLS & VISION OPTOMETRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 N WELLS ST
CHICAGO IL
60654-3521
US
IV. Provider business mailing address
740 N WELLS ST
CHICAGO IL
60654-3521
US
V. Phone/Fax
- Phone: 312-702-0240
- Fax: 312-736-8232
- Phone: 312-702-0240
- Fax: 312-736-8232
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GRETA
GREGG
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 847-962-5451