Provider Demographics
NPI:1467593004
Name:DES PLAINES EYE PHYSICIANS & SURGEONS, LTD.
Entity Type:Organization
Organization Name:DES PLAINES EYE PHYSICIANS & SURGEONS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-299-5501
Mailing Address - Street 1:940 LEE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6555
Mailing Address - Country:US
Mailing Address - Phone:847-299-5501
Mailing Address - Fax:
Practice Address - Street 1:940 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6555
Practice Address - Country:US
Practice Address - Phone:847-299-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-066311261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0146500001Medicare NSC
IL211921Medicare PIN
ILC43180Medicare UPIN