Provider Demographics
NPI:1386661379
Name:CHICAGO GLAUCOMA CONSULTANTS LTD
Entity Type:Organization
Organization Name:CHICAGO GLAUCOMA CONSULTANTS LTD
Other - Org Name:STEVEN V.L. BROWN, MD, SC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-510-6000
Mailing Address - Street 1:2640 PATRIOT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8075
Mailing Address - Country:US
Mailing Address - Phone:847-510-6000
Mailing Address - Fax:847-832-0905
Practice Address - Street 1:2640 PATRIOT BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8075
Practice Address - Country:US
Practice Address - Phone:847-510-6000
Practice Address - Fax:847-832-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060627207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601081OtherBCBS #
IL31601081OtherBCBS #
IL334250Medicare ID - Type UnspecifiedMEDICARE GRP #