Provider Demographics
NPI:1033345798
Name:METROPOLITAN EYECARE BEECHER
Entity Type:Organization
Organization Name:METROPOLITAN EYECARE BEECHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:708-946-9130
Mailing Address - Street 1:1140 S DIXIE HWY STE B
Mailing Address - Street 2:
Mailing Address - City:BEECHER
Mailing Address - State:IL
Mailing Address - Zip Code:60401-3672
Mailing Address - Country:US
Mailing Address - Phone:708-946-9130
Mailing Address - Fax:708-748-6079
Practice Address - Street 1:1140 S DIXIE HWY STE B
Practice Address - Street 2:
Practice Address - City:BEECHER
Practice Address - State:IL
Practice Address - Zip Code:60401-3672
Practice Address - Country:US
Practice Address - Phone:708-946-9130
Practice Address - Fax:708-748-6079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008862152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty