Provider Demographics
NPI:1154818847
Name:CHIZEK FAMILY EYECARE INC
Entity Type:Organization
Organization Name:CHIZEK FAMILY EYECARE INC
Other - Org Name:BETTENDORF EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMMIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHIZEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:563-285-4001
Mailing Address - Street 1:1875 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3203
Mailing Address - Country:US
Mailing Address - Phone:563-359-4446
Mailing Address - Fax:563-359-0381
Practice Address - Street 1:251 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748
Practice Address - Country:US
Practice Address - Phone:563-285-4001
Practice Address - Fax:563-285-6121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIZEK FAMILY EYECARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-18
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty