Provider Demographics
NPI:1033371869
Name:GUSSIS, MURRY S (OD)
Entity Type:Individual
Prefix:
First Name:MURRY
Middle Name:S
Last Name:GUSSIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-2225
Mailing Address - Country:US
Mailing Address - Phone:224-699-9252
Mailing Address - Fax:
Practice Address - Street 1:365 LAKE MARIAN RD
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-2096
Practice Address - Country:US
Practice Address - Phone:847-426-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006970152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist