Provider Demographics
NPI:1578626388
Name:HAMPTON, PEARLINE (OD)
Entity Type:Individual
Prefix:DR
First Name:PEARLINE
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 N ELSTON AVE
Mailing Address - Street 2:#2661
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2018
Mailing Address - Country:US
Mailing Address - Phone:773-394-7029
Mailing Address - Fax:773-394-7040
Practice Address - Street 1:2663 N ELSTON AVE
Practice Address - Street 2:#2661
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2018
Practice Address - Country:US
Practice Address - Phone:773-394-7029
Practice Address - Fax:773-394-7040
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-007067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist