Organization
BRIAN DEMBO,O.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MARC DEMBO O.D. (PRESIDENT)
(847) 998-6700
Entity
Organization
Contact information
Practice address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 998-6700
Mailing address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 998-6700
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
05
—
046008000
—
IL
Enumeration date
07/15/2008
Last updated
08/29/2008
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