Provider Demographics
NPI:1194183962
Name:KAMRAN HUSSAIN INCORPORATED
Entity Type:Organization
Organization Name:KAMRAN HUSSAIN INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-965-2660
Mailing Address - Street 1:524 LAWLER AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2031
Mailing Address - Country:US
Mailing Address - Phone:847-965-2660
Mailing Address - Fax:847-965-0250
Practice Address - Street 1:7107 W DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2131
Practice Address - Country:US
Practice Address - Phone:847-965-2660
Practice Address - Fax:847-965-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty