NPI 1770992448

Northwestern Medical Faculty Foundation

Organisation Optometrist Grayslake, IL

Practice location

Address: 1475 E Belvidere Rd Suite# 1297, Grayslake, IL 60030-2012
Phone: (847) 295-0001
Mailing address: 680 N Lake Shore Dr Suite# 1000, Chicago, IL 60611-8709

Authorised official

Name: Justin A. Johnson
Title: Vp,cfo
Phone: (312) 926-1599

Registered specialties (3)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X

Other Optometrist providers in Illinois →

Corneal and Contact Management Optometrist

Eye and Vision Services Providers Taxonomy 152WC0802X

Vision Therapy Optometrist

Eye and Vision Services Providers Taxonomy 152WV0400X

Registry record

NPI: 1770992448
Entity type: Organization
NPI issued: 7 Aug 2014
Record last updated: 23 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.