Provider Demographics
NPI:1023773991
Name:EYES ON GRAND LLC
Entity type:Organization
Organization Name:EYES ON GRAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSALBA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-737-5875
Mailing Address - Street 1:10112 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2549
Mailing Address - Country:US
Mailing Address - Phone:847-737-5875
Mailing Address - Fax:847-737-5876
Practice Address - Street 1:10116 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2549
Practice Address - Country:US
Practice Address - Phone:630-550-2377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty