Provider Demographics
NPI:1376608083
Name:EYE CARE 4 U, S.C.
Entity Type:Organization
Organization Name:EYE CARE 4 U, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:FISCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-656-0428
Mailing Address - Street 1:5455 SHERIDAN RD
Mailing Address - Street 2:LL20
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-3734
Mailing Address - Country:US
Mailing Address - Phone:262-656-0428
Mailing Address - Fax:262-656-1623
Practice Address - Street 1:5455 SHERIDAN RD
Practice Address - Street 2:LL20
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3734
Practice Address - Country:US
Practice Address - Phone:262-656-0428
Practice Address - Fax:262-656-1623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152W00000X310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1936-TPAOtherLICENSE
WI38523300Medicaid
WI152W00000XOtherTAXONOMY
WI152W00000XOtherTAXONOMY
WI152W00000XOtherTAXONOMY
WI=========BOtherHUMANA
WIMF0093221OtherDEA
WI1936-TPAOtherLICENSE
WI87459Medicare PIN