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General NPI Number Information
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NPI Number | 1881335719
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Entity Type | Organization
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Legal Business Name | EXPERT FAMILY EYECARE LLC
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 185 MILWAUKEE AVE STE 110
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3085
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Country | US
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Telephone | 224-623-2095
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Fax |
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Provider Business Mailing Address
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Address Line | 520 MUIRFIELD LN
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City | RIVERWOODS
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State | IL
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Zip | 60015-3881
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | VERONICA KACHEROVA
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Credential | OD
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Telephone | 224-623-2095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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