Provider Demographics
NPI:1659795714
Name:EYE Q OPTIQUE, INC.
Entity Type:Organization
Organization Name:EYE Q OPTIQUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
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 1:1855 W TAYLOR ST
Mailing Address - Street 2:STE. 1.075
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1855 W TAYLOR ST
Practice Address - Street 2:STE. 1.075
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7242
Practice Address - Country:US
Practice Address - Phone:312-996-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier