Provider Demographics
NPI:1003949777
Name:EYE SURGEONS SC
Entity Type:Organization
Organization Name:EYE SURGEONS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-743-4300
Mailing Address - Street 1:5330 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4108
Mailing Address - Country:US
Mailing Address - Phone:773-775-4947
Mailing Address - Fax:773-775-5109
Practice Address - Street 1:5330 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4108
Practice Address - Country:US
Practice Address - Phone:773-775-4947
Practice Address - Fax:773-775-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty