Provider Demographics
NPI:1225326929
Name:VISION CARE CONSULTANTS, LTD
Entity Type:Organization
Organization Name:VISION CARE CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-837-1400
Mailing Address - Street 1:1308 S MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3795
Mailing Address - Country:US
Mailing Address - Phone:847-837-1400
Mailing Address - Fax:847-837-1440
Practice Address - Street 1:1308 S. MILWAUKEE AVE.
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-2366
Practice Address - Country:US
Practice Address - Phone:847-837-1400
Practice Address - Fax:847-837-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009344Medicaid
IL046009344Medicaid