EDGEBROOK VISION CENTER LLC (NPI# 1477995074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477995074 |
| Entity Type | Organization |
| Organization Name | EDGEBROOK VISION CENTER LLC |
| Practice Address |
5315 W Devon Ave Chicago IL 60646-4107 |
| Practice Telephone | 7737756555 |
| Practice Fax Number | 7737753350 |
| Mailing Telephone | 7737756555 |
| Mailing Fax Number | 7737753350 |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |
| Authorized Official Name | MS. ROSEMARY THERESA KAFKA (PRESIDENT) |
| Authorized Official Telephone | 7735509667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Street Address |
5315 W DEVON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891900668 | Christine Kafka Vicere | Optometrist | 5315 W Devon Ave, Chicago, IL 60646-4107 | 2007-05-14 |
| 1770109787 | Ameera Sulakhe, O.d. Inc. | Optometrist | 5315 W Devon Ave, Chicago, IL 60646-4102 | 2020-06-25 |
| 1619330263 | Ameera Sulakhe | Optometrist | 5315 W Devon Ave, Chicago, IL 60646-4102 | 2016-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129294 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 900 W North Ave, Chicago, IL 60642-2506 | 2020-06-23 |
| 1710512488 | Glasses On Oak St | Eyewear Supplier (Equipment, not the service) | 900 N Michigan Ave Fl 5, Chicago, IL 60611-1542 | 2020-03-03 |
| 1518526789 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 851 W Randolph St Spc 2, Chicago, IL 60607-2310 | 2019-06-11 |
| 1679037642 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 135 S Lasalle St, Chicago, IL 60603 | 2019-01-24 |
| 1346713344 | Fullerton Vision LLC | Eyewear Supplier (Equipment, not the service) | 4959 W Fullerton Ave, Chicago, IL 60639-2505 | 2019-01-02 |
| 1386127892 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3432 N Southport Ave, Chicago, IL 60657-8289 | 2018-09-11 |
| 1073020335 | Luxury Eyesight, LLC | Eyewear Supplier (Equipment, not the service) | 1457 N Halsted St Unit B101, Chicago, IL 60642-2676 | 2018-01-08 |
| 1023535382 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1123 N State St, Chicago, IL 60610-2717 | 2017-08-28 |
| 1972020238 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 851 W Armitage Ave, Chicago, IL 60614-4328 | 2017-08-28 |
| 1528503042 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 908 North State Street, Chicago, IL 60610 | 2016-12-20 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.