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Contact Information

KEVIN BLACKETT, OD
1730 W FULLERTON AVE
CHICAGO, IL60614-1900
 Phone: 773-327-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KEVIN BLACKETT · (Male)

NPI Number 1679256978
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/11/2023
Last updated 08/11/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 046.011746
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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