Organization
EVANSTON EYE WELLNESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEANA LABROSSE O.D. (PRESIDENT)
(847) 350-7952
Entity
Organization
Contact information
Practice address
716 MAIN ST, EVANSTON, IL 60202-1816
(847) 350-7952
(847) 929-9764
Mailing address
716 MAIN ST, EVANSTON, IL 60202-1816
(847) 350-7952
(847) 929-9764
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009750
—
IL
Enumeration date
09/23/2015
Last updated
01/08/2016
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