Provider Demographics
NPI:1477676914
Name:ACCUVISION CENTER INC.
Entity Type:Organization
Organization Name:ACCUVISION CENTER INC.
Other - Org Name:ACCUVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-274-6000
Mailing Address - Street 1:1914 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-7822
Mailing Address - Country:US
Mailing Address - Phone:847-356-2020
Mailing Address - Fax:847-356-5051
Practice Address - Street 1:1914 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-7822
Practice Address - Country:US
Practice Address - Phone:847-356-2020
Practice Address - Fax:847-356-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1831141753OtherDR. CHRIS DEROSE NPI #
IL4919690OtherBCBS IL GROUP NUMBER
IL1306886932OtherDR KWON NPI #
IL1427001718OtherDR DOHERTY NPI #
IL200397Medicare ID - Type UnspecifiedGROUP NUMBER
ILU94607Medicare UPIN
IL1306886932OtherDR KWON NPI #
IL4919690OtherBCBS IL GROUP NUMBER