Provider Demographics
NPI:1407978687
Name:CARR EYE PROFESSIONALS PC
Entity Type:Organization
Organization Name:CARR EYE PROFESSIONALS PC
Other - Org Name:ORLAND EYE PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASST.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-403-0123
Mailing Address - Street 1:14315 108TH AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5700
Mailing Address - Country:US
Mailing Address - Phone:708-403-0123
Mailing Address - Fax:
Practice Address - Street 1:14315 108TH AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5700
Practice Address - Country:US
Practice Address - Phone:708-403-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008711152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL987920Medicare PIN
ILT37496Medicare UPIN