Provider Demographics
NPI:1073849931
Name:RUCNOK VISION CARE INC
Entity Type:Organization
Organization Name:RUCNOK VISION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GIANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-942-5918
Mailing Address - Street 1:5021 ESSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5522
Mailing Address - Country:US
Mailing Address - Phone:815-942-5918
Mailing Address - Fax:815-942-4794
Practice Address - Street 1:333 E US ROUTE 6
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-8920
Practice Address - Country:US
Practice Address - Phone:815-942-5918
Practice Address - Fax:815-942-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006846152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046006846OtherLICENSE
IL046006846Medicaid
ILMG0211069OtherDEA