Vision Gallery

LBN: Gm Revelle Inc
Vision Gallery is an health care organization with primary practice located at 2820 Plainfield Rd , Joliet IL 60435-1167. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Gm Revelle Inc can be contacted via phone (815) 436-1144, or through Dettmann, Dennis E via phone (815) 436-1144.

Contact Information

Primary practice address
2820 Plainfield Rd Joliet IL 60435-1167
Phone: (815) 436-1144
Fax: (815) 436-1260
Website:
Map and Directions
Authorized official contact:
Name: Dettmann, Dennis E Doctor of Optometry (OD)
Phone: (815) 436-1144

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1972597342
LBN Legal business name Gm Revelle Inc
DBA Doing business as Vision Gallery
Authorized official Dettmann, Dennis E Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2005
Last updated Apr 30th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972597342 NPPES
Illinois MEDICAID 046007054
Illinois Other 9932299

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