MEDICARE: DR. KARYN BASSETT O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046.010299	IL

General Provider Information

NPI Number	:	1023344835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARYN BASSETT O.D.

Provider Business Mailing Address
First Line	:	1600 N SR 50
Second Line	:	PEARLE VISION
City	:	BOURBONNAIS
State	:	IL
Zip	:	60914-9307
Country	:	US
Telephone Number	:	815-935-0404
Fax Number	:	815-935-0489

Provider Business Practice Location Address
First Line	:	1600 N SR 50
Second Line	:	PEARLE VISION
City	:	BOURBONNAIS
State	:	IL
Zip	:	60914-9307
Country	:	US
Telephone Number	:	815-935-0404
Fax Number	:	815-935-0489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	07/21/2022

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