1497834998 NPI number — SLOANE VISION SERVICES, LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497834998 NPI number — SLOANE VISION SERVICES, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLOANE VISION SERVICES, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SLOANE VISION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497834998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 WEST 22ND STREET
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
OAK BROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-368-6100
Provider Business Mailing Address Fax Number:
630-368-6060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 WEST 22ND STREET
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
OAK BROOK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-368-6100
Provider Business Practice Location Address Fax Number:
630-368-6060
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SLOANE
Authorized Official First Name:
HERMAN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
630-368-6100

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  036062667 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1225008139 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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