Healthcare Provider Details

I. General information

NPI: 1619590403
Provider Name (Legal Business Name): DANA HOBI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

782 W OAKTON ST STE A
DES PLAINES IL
60018-1857
US

IV. Provider business mailing address

1819 S MICHIGAN AVE UNIT 803
CHICAGO IL
60616-4644
US

V. Phone/Fax

Practice location:
  • Phone: 847-977-9033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNA2906
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3872-35
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003884
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTPOP108
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number030.0133976
License Number StateVT
# 6
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046011414
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: