Provider Demographics
NPI:1043061252
Name:EYE Q OPTIQUE INC
Entity type:Organization
Organization Name:EYE Q OPTIQUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NARMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSEYNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-872-0201
Mailing Address - Street 1:722 S. BUFFALO GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089
Mailing Address - Country:US
Mailing Address - Phone:312-872-0201
Mailing Address - Fax:847-589-1375
Practice Address - Street 1:1950 W POLK ST RM 1101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3723
Practice Address - Country:US
Practice Address - Phone:312-872-0201
Practice Address - Fax:847-589-1375
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE Q OPTIQUE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier