Healthcare Provider Details

I. General information

NPI: 1467791376
Provider Name (Legal Business Name): EYE SOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 WARREN ST
EVANSTON IL
60202-1949
US

IV. Provider business mailing address

1925 WARREN ST
EVANSTON IL
60202-1949
US

V. Phone/Fax

Practice location:
  • Phone: 847-840-3216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number046009750
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046009750
License Number StateIL

VIII. Authorized Official

Name: DR. DEANA LABROSSE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 847-840-3216