Healthcare Provider Details

I. General information

NPI: 1144288689
Provider Name (Legal Business Name): VISION SURGEONS AND CONSULTANTS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 AUSTIN ST EAST TOWER STE 151
EVANSTON IL
60202-3439
US

IV. Provider business mailing address

5501 W 79TH ST SUITE 400
BURBANK IL
60459-1784
US

V. Phone/Fax

Practice location:
  • Phone: 847-328-2300
  • Fax: 847-492-1988
Mailing address:
  • Phone: 773-884-4523
  • Fax: 773-884-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CARRIE GOLDEN-BRENNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-328-2300