Healthcare Provider Details

I. General information

NPI: 1750468518
Provider Name (Legal Business Name): CHICAGO CORNEA CONSULTANTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 CENTRAL AVE STE 300
HIGHLAND PARK IL
60035-5613
US

IV. Provider business mailing address

806 CENTRAL AVE STE 300
HIGHLAND PARK IL
60035-5613
US

V. Phone/Fax

Practice location:
  • Phone: 847-432-6010
  • Fax: 847-432-8241
Mailing address:
  • Phone: 847-432-6010
  • Fax: 847-432-8241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number042006466
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number042116466
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number042006466
License Number StateIL

VIII. Authorized Official

Name: MR. JEFF D NICHOLS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 847-432-6010