Provider Demographics
NPI:1184065898
Name:NESBITT, DANIELLE JULIENNE (OD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:JULIENNE
Last Name:NESBITT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:KARACSONYI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:875 N MILWAUKEE AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-3167
Practice Address - Country:US
Practice Address - Phone:847-325-4440
Practice Address - Fax:847-325-4443
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210209OtherMEDICARE GROUP
IL7235044OtherAETNA
IL8825444OtherMULTIPLAN
IL1636706OtherBCBS
IL211019OtherMEDICARE GROUP
IL211019OtherMEDICARE GROUP