Provider Demographics
NPI: | 1467022608 |
---|---|
Name: | ADVANCED EYECARE OF ARLINGTON HEIGHTS CORP |
Entity Type: | Organization |
Organization Name: | ADVANCED EYECARE OF ARLINGTON HEIGHTS CORP |
Other - Org Name: | SPECIAL EYES OPTICAL |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GRISHMA |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | PATEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 847-368-9800 |
Mailing Address - Street 1: | 27 S VAIL AVE # 1840 |
Mailing Address - Street 2: | |
Mailing Address - City: | ARLINGTON HEIGHTS |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60005-1840 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-368-9800 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 27 S VAIL AVE # 1840 |
Practice Address - Street 2: | |
Practice Address - City: | ARLINGTON HEIGHTS |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60005-1840 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-368-9800 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-06-29 |
Last Update Date: | 2024-02-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |