Healthcare Provider Details

I. General information

NPI: 1093902686
Provider Name (Legal Business Name): SHVARTSMAN EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SKOKIE BLVD
WILMETTE IL
60091-3050
US

IV. Provider business mailing address

323 17TH ST
WILMETTE IL
60091-3223
US

V. Phone/Fax

Practice location:
  • Phone: 847-251-3330
  • Fax: 847-251-9580
Mailing address:
  • Phone: 847-853-0763
  • Fax: 847-251-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. DEANNE LYNNE SHVARTSMAN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 847-853-0763