Individual
DR. BRIAN MARC DEMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 998-6700
(847) 998-1566
Mailing address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 998-6700
(847) 998-1566
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008000
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01684637
BLUE CROSS BLUE SHIELD
IL
01
—
021151001
ADMINISTAR FEDERAL
—
05
—
046008000
—
IL
Enumeration date
06/28/2006
Last updated
12/05/2008
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