Provider Demographics
NPI:1528559846
Name:SERPICO FAMILY EYE CARE, INC.
Entity Type:Organization
Organization Name:SERPICO FAMILY EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SERPICO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-924-6452
Mailing Address - Street 1:6 E PHILLIP RD STE 1110
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1700
Mailing Address - Country:US
Mailing Address - Phone:847-816-9996
Mailing Address - Fax:847-816-3142
Practice Address - Street 1:6 E PHILLIP RD STE 1110
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1700
Practice Address - Country:US
Practice Address - Phone:847-816-9996
Practice Address - Fax:847-816-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009099152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty