=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922783836
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SIGHT TO SEE EYECARE & EYEWEAR, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2023
-----------------------------------------------------
Last Update Date | 07/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 KANEVILLE RD STE 8
-----------------------------------------------------
City | GENEVA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60134-2577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-326-4417
-----------------------------------------------------
Fax | 630-326-8764
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 KANEVILLE RD STE 8
-----------------------------------------------------
City | GENEVA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60134-2577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPTOMETRIST
-----------------------------------------------------
Name | DR. GRIFFIN DURIAS
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 630-326-4417
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------