Provider Demographics
NPI:1649647967
Name:BRIGHT EYES FAMILY VISION, INC
Entity type:Organization
Organization Name:BRIGHT EYES FAMILY VISION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PULSFUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:224-569-1001
Mailing Address - Street 1:2401 W US HIGHWAY 20
Mailing Address - Street 2:UNIT 107
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-8818
Mailing Address - Country:US
Mailing Address - Phone:224-569-1001
Mailing Address - Fax:847-423-6090
Practice Address - Street 1:2401 W US HIGHWAY 20
Practice Address - Street 2:UNIT 107
Practice Address - City:PINGREE GROVE
Practice Address - State:IL
Practice Address - Zip Code:60140-8818
Practice Address - Country:US
Practice Address - Phone:224-569-1001
Practice Address - Fax:847-423-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010411152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty