Organization
NORTHERN ILLINOIS EYE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY VELOTTA M.D. (PRESIDENT)
(847) 668-5109
Entity
Organization
Contact information
Practice address
333 E IL ROUTE 83, 106, MUNDELEIN, IL 60060-4214
(847) 566-5300
Mailing address
19523 W BRAE LOCH RD, GRAYSLAKE, IL 60030-1307
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Enumeration date
12/06/2011
Last updated
02/01/2025
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