Provider Demographics
NPI:1487886974
Name:DOWLING, BRIAN MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:DOWLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2706 N MILWAUKEE AVE
Mailing Address - Street 2:PEARLE VISION
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1308
Mailing Address - Country:US
Mailing Address - Phone:773-862-5000
Mailing Address - Fax:773-862-5059
Practice Address - Street 1:2706 N MILWAUKEE AVE
Practice Address - Street 2:PEARLE VISION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1308
Practice Address - Country:US
Practice Address - Phone:773-862-5000
Practice Address - Fax:773-862-5059
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2757152W00000X
IL046-010310152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist