Bravo Eyecare PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BRAVO EYECARE PLLC

Practice address

3900 Fountain Square PL
Waukegan, IL 60085-6708

Phone

(847) 473-2568

NPI assigned

Aug 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Albert LiaoNPI 1346408176

Title

Owner

Phone

(847) 473-2568

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert Ya-Dek Liao, O.D.

  • Optometrist
  • Waukegan, IL
  • NPI 1346408176
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1346023835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 OXFORD DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 FOUNTAIN SQUARE PL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856708",
            "telephone_number": "847-473-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "LIAO",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-473-2568"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Bradford
• Sara Bradley
• Timothy Brandt
• Tara Shawnise Brannon
• Brianna Marie Brasewicz
• Brianna Bravo
• Cristina Bravo
• Caitlin Brehm, B.A
• Blair Brenner
• Nana Brentuo

• Optometrist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.