Provider Demographics
NPI:1518154129
Name:LESCHER VILLAGE EYE PHYSICIANS, S.C.
Entity Type:Organization
Organization Name:LESCHER VILLAGE EYE PHYSICIANS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-848-4353
Mailing Address - Street 1:1046 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1842
Mailing Address - Country:US
Mailing Address - Phone:708-848-4353
Mailing Address - Fax:708-848-4821
Practice Address - Street 1:1046 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1842
Practice Address - Country:US
Practice Address - Phone:708-848-4353
Practice Address - Fax:708-848-4821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty