=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497881502
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOCUS EYE CARE, LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2007
-----------------------------------------------------
Last Update Date | 12/11/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1763 FREEDOM DRIVE SUITE 129
-----------------------------------------------------
City | NAPERVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60563-3550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-393-5663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2092 WILSON CREEK CIR
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60503-3611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-545-4157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. AMBER LYNN DAWSON
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 312-545-4157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 046009081
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------