Healthcare Provider Details

I. General information

NPI: 1922123462
Provider Name (Legal Business Name): DAWN KAPLAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. DAWN KAPLAN

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 12/20/2020
Certification Date: 10/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25901 N RIVERWOODS RD
METTAWA IL
60045-3403
US

IV. Provider business mailing address

1600 MONTGOMERY RD
DEERFIELD IL
60015-2631
US

V. Phone/Fax

Practice location:
  • Phone: 847-235-1313
  • Fax: 847-235-1312
Mailing address:
  • Phone: 773-220-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046-008728
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: