Healthcare Provider Details
I. General information
NPI: 1225240369
Provider Name (Legal Business Name): EYE LEVEL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 N. LA SALLE STREET SUITE 155
CHICAGO IL
60602
US
IV. Provider business mailing address
2 N. LA SALLE STREET SUITE 155
CHICAGO IL
60602
US
V. Phone/Fax
- Phone: 312-236-7538
- Fax: 312-236-1205
- Phone: 312-236-7538
- Fax: 312-236-1205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALAN
KARIKOMI
Title or Position: OWNER
Credential: OD
Phone: 312-236-7538