Provider Demographics
NPI:1144379850
Name:UNGER EYE CARE PC
Entity Type:Organization
Organization Name:UNGER EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:618-667-2020
Mailing Address - Street 1:534 EDWARDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-1338
Mailing Address - Country:US
Mailing Address - Phone:618-667-2020
Mailing Address - Fax:
Practice Address - Street 1:534 EDWARDSVILLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-1338
Practice Address - Country:US
Practice Address - Phone:618-667-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.008303152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046008423Medicaid
ILCJ3828OtherDR. THOMAS UNGER
IL046008303Medicaid
ILCJ3828OtherDR. ALICE UNGER
ILT92346Medicare UPIN
ILCJ3828OtherDR. THOMAS UNGER
IL205951Medicare PIN
ILCJ3828OtherDR. ALICE UNGER
IL928581Medicare PIN