Provider Demographics
NPI:1134306707
Name:JASS EYECARE P.C.
Entity Type:Organization
Organization Name:JASS EYECARE P.C.
Other - Org Name:BARTLETT EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-953-0471
Mailing Address - Street 1:986 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-6500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:986 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-6500
Practice Address - Country:US
Practice Address - Phone:630-837-7630
Practice Address - Fax:630-837-3292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
410027281OtherRAILROAD PALAMENTO GBA
U-92565Medicare UPIN
410027281OtherRAILROAD PALAMENTO GBA
IL0925030001Medicare NSC
IL999610Medicare PIN
IL230302Medicare PIN