Provider Demographics
NPI:1932771623
Name:EYE CARE BY DESIGN, LLC
Entity Type:Organization
Organization Name:EYE CARE BY DESIGN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZZRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOBANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO
Authorized Official - Phone:312-761-9660
Mailing Address - Street 1:1228 W MONROE ST UNIT 509
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2581
Mailing Address - Country:US
Mailing Address - Phone:312-451-9496
Mailing Address - Fax:
Practice Address - Street 1:1850 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5512
Practice Address - Country:US
Practice Address - Phone:312-761-9660
Practice Address - Fax:312-761-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty