Provider Demographics
NPI:1336694108
Name:THE CENTER FOR CORRECTIVE EYE SURGERY, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR CORRECTIVE EYE SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-778-0415
Mailing Address - Street 1:5400 W ELM ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-4010
Mailing Address - Country:US
Mailing Address - Phone:815-363-2020
Mailing Address - Fax:224-778-5134
Practice Address - Street 1:5400 W ELM ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-4010
Practice Address - Country:US
Practice Address - Phone:815-363-2020
Practice Address - Fax:224-778-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13929Medicare UPIN