Provider Demographics
NPI:1235489469
Name:EYE Q OPTIQUE INC
Entity Type:Organization
Organization Name:EYE Q OPTIQUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NARMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSEYNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-947-8875
Mailing Address - Street 1:722 S BUFFALO GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3708
Mailing Address - Country:US
Mailing Address - Phone:847-947-8875
Mailing Address - Fax:847-589-1375
Practice Address - Street 1:722 S BUFFALO GROVE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3708
Practice Address - Country:US
Practice Address - Phone:847-947-8875
Practice Address - Fax:847-589-1375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X, 156FX1800X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty