Provider Demographics
NPI:1003078577
Name:CHANDER VISION GROUP LTD
Entity Type:Organization
Organization Name:CHANDER VISION GROUP LTD
Other - Org Name:PRIMARY EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDIP
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-735-6090
Mailing Address - Street 1:5460 S ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-3033
Mailing Address - Country:US
Mailing Address - Phone:773-735-6090
Mailing Address - Fax:773-581-0320
Practice Address - Street 1:5460 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-3033
Practice Address - Country:US
Practice Address - Phone:773-735-6090
Practice Address - Fax:773-581-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0468891152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8392074OtherCIGNA
IL01623496OtherBLUE CROSS BLUE SHIELD
IL1291390001Medicare NSC
IL01623496OtherBLUE CROSS BLUE SHIELD