Healthcare Provider Details

I. General information

NPI: 1700125507
Provider Name (Legal Business Name): OPSIS EYEWEAR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 W. GARTNER RD. SUITE 116
NAPERVILLE IL
60540-7523
US

IV. Provider business mailing address

152 W. GARTNER RD. SUITE 116
NAPERVILLE IL
60540-7523
US

V. Phone/Fax

Practice location:
  • Phone: 630-210-8660
  • Fax: 630-210-8682
Mailing address:
  • Phone: 630-210-8660
  • Fax: 630-210-8682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046010399
License Number StateIL

VIII. Authorized Official

Name: DR. PRANALI SIROHI
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 630-335-7030