Provider Demographics
NPI:1316032337
Name:SUBURBAN ASSOCIATES IN OPHTHALMOLOGY LLC
Entity Type:Organization
Organization Name:SUBURBAN ASSOCIATES IN OPHTHALMOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURNYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-253-4040
Mailing Address - Street 1:1100 W CENTRAL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2465
Mailing Address - Country:US
Mailing Address - Phone:847-253-4040
Mailing Address - Fax:847-253-3028
Practice Address - Street 1:1100 W CENTRAL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2465
Practice Address - Country:US
Practice Address - Phone:847-253-4040
Practice Address - Fax:847-253-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001623492OtherBCBS IL
IL0585590001Medicare NSC
571890Medicare ID - Type Unspecified
IL204544Medicare PIN