Healthcare Provider Details

I. General information

NPI: 1659497071
Provider Name (Legal Business Name): DENNIS DELEE, O.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S LA SALLE ST STE 120
CHICAGO IL
60604-1219
US

IV. Provider business mailing address

209 S LA SALLE ST STE 120
CHICAGO IL
60604-1219
US

V. Phone/Fax

Practice location:
  • Phone: 312-332-4461
  • Fax: 312-332-5970
Mailing address:
  • Phone: 312-332-4461
  • Fax: 312-332-5970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number46-006526
License Number StateIL

VIII. Authorized Official

Name: DR. DENNIS DELEE
Title or Position: PRES
Credential: O.D.
Phone: 312-332-4461