1952454647 NPI number — EYE CARE LTD

Table of content: (NPI 1952454647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952454647 NPI number — EYE CARE LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE CARE 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:
EYECARE EYEWEAR LTD
Provider Other Organization Name Type Code:
4
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:
1952454647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9630 KENTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SKOKIE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60076-1216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-677-1699
Provider Business Mailing Address Fax Number:
847-677-1406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1971 2ND ST
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
HIGHLAND PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60035-3174
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-433-5888
Provider Business Practice Location Address Fax Number:
847-433-6224
Provider Enumeration Date:
01/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YOUEL
Authorized Official First Name:
MONA
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTICAL MANAGER
Authorized Official Telephone Number:
847-433-5888

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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