Healthcare Provider Details

I. General information

NPI: 1750566188
Provider Name (Legal Business Name): THE MIND-EYE CONNECTION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 TECHNY RD
NORTHBROOK IL
60062-5447
US

IV. Provider business mailing address

1414 TECHNY RD
NORTHBROOK IL
60062-5447
US

V. Phone/Fax

Practice location:
  • Phone: 847-501-2020
  • Fax: 847-501-2021
Mailing address:
  • Phone: 847-501-2020
  • Fax: 847-501-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number046007834
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number046007834
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number046007834
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046007834
License Number StateIL

VIII. Authorized Official

Name: DR. DEBORAH GAIL ZELINSKY
Title or Position: OWNER
Credential: O.D.
Phone: 847-501-2020