Provider Demographics
NPI:1346586922
Name:LILAS EYE CARE AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LILAS EYE CARE AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EFFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LILAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:708-935-5100
Mailing Address - Street 1:15509 NOLAN CT
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-7432
Mailing Address - Country:US
Mailing Address - Phone:708-403-7895
Mailing Address - Fax:708-403-9260
Practice Address - Street 1:14706 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3227
Practice Address - Country:US
Practice Address - Phone:708-403-7895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010018152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1376736769OtherTYPE 1 INDIVIDUAL NPI