Provider Demographics
NPI:1063699510
Name:CHICAGOLAND VISION CONSULTANTS
Entity type:Organization
Organization Name:CHICAGOLAND VISION CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-477-5612
Mailing Address - Street 1:2746 N CLYBOURN AVE
Mailing Address - Street 2:OPTICAL DEPT - DOCTOR'S OFFICE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1006
Mailing Address - Country:US
Mailing Address - Phone:773-360-2056
Mailing Address - Fax:
Practice Address - Street 1:1375 N MEACHAM RD
Practice Address - Street 2:OPTICAL DEPT - DOCTOR'S OFFICE
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4805
Practice Address - Country:US
Practice Address - Phone:847-969-0867
Practice Address - Fax:847-496-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty