Provider Demographics
NPI:1275721169
Name:NORTH SUBURBAN EYE ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:NORTH SUBURBAN EYE ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-945-4188
Mailing Address - Street 1:925 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2203
Mailing Address - Country:US
Mailing Address - Phone:847-945-4188
Mailing Address - Fax:847-945-8338
Practice Address - Street 1:925 NORTH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-2203
Practice Address - Country:US
Practice Address - Phone:847-945-4188
Practice Address - Fax:847-945-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-42592207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty