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Contact Information

DANIELLE J IRVINE, OD
309 N FRANKLIN ST
PORT WASHINGTON, WI53074-1905
 Phone: 262-261-5252
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Low Vision Rehabilitation

152WL0500X 41 Optometry
Indicates primary specialty

NPI Profile & details for DANIELLE J IRVINE · (Female)

NPI # 1760745871
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 06/22/2012
Last updated 10/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 046010557
  • WI License # 3589-35
  • IL Medicaid 046010557
  • IL Other 502720065 MEDICARE PTAN
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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