Provider Demographics
NPI:1194084350
Name:EYE HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:EYE HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:PARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-266-2036
Mailing Address - Street 1:1066 MCKNIGHT CIR
Mailing Address - Street 2:APT 2
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6403
Mailing Address - Country:US
Mailing Address - Phone:815-266-2036
Mailing Address - Fax:815-266-2058
Practice Address - Street 1:2545 IL ROUTE 26 S
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-9370
Practice Address - Country:US
Practice Address - Phone:815-266-2036
Practice Address - Fax:815-266-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-010186152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046-010186OtherOD LICENSE