Healthcare Provider Details
I. General information
NPI: 1801460928
Provider Name (Legal Business Name): SOLO EYE CARE & EYEWEAR GALLERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 E DELAWARE PL
CHICAGO IL
60611-1449
US
IV. Provider business mailing address
1444 S MICHIGAN AVE
CHICAGO IL
60605-4827
US
V. Phone/Fax
- Phone: 312-588-5999
- Fax: 312-588-0599
- Phone: 312-588-5999
- Fax: 312-588-0599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
JOHN
STEINMETZ
Title or Position: OWNER / DOCTOR
Credential: OD
Phone: 312-588-5999