Provider Demographics
NPI:1982446704
Name:LUMINOUS EYECARE, PLLC
Entity type:Organization
Organization Name:LUMINOUS EYECARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:WOZNY
Authorized Official - Last Name:GLEBIV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-389-5409
Mailing Address - Street 1:6013 N CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4301
Mailing Address - Country:US
Mailing Address - Phone:773-389-5409
Mailing Address - Fax:773-389-5405
Practice Address - Street 1:6013 N CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4301
Practice Address - Country:US
Practice Address - Phone:773-389-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist