Provider Demographics
NPI:1700125507
Name:OPSIS EYEWEAR, LLC
Entity Type:Organization
Organization Name:OPSIS EYEWEAR, LLC
Other - Org Name:THE EYE WORLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SIROHI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-335-7030
Mailing Address - Street 1:152 W. GARTNER RD.
Mailing Address - Street 2:SUITE 116
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7523
Mailing Address - Country:US
Mailing Address - Phone:630-210-8660
Mailing Address - Fax:630-210-8682
Practice Address - Street 1:152 W. GARTNER RD.
Practice Address - Street 2:SUITE 116
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7523
Practice Address - Country:US
Practice Address - Phone:630-210-8660
Practice Address - Fax:630-210-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010399152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046010399Medicaid