Provider Demographics
NPI:1538458294
Name:NEUKIRCH VISION CARE LLC
Entity Type:Organization
Organization Name:NEUKIRCH VISION CARE LLC
Other - Org Name:CARILLON VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NEUKIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-657-8787
Mailing Address - Street 1:1900 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1714
Mailing Address - Country:US
Mailing Address - Phone:847-657-8787
Mailing Address - Fax:847-657-8730
Practice Address - Street 1:1900 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1714
Practice Address - Country:US
Practice Address - Phone:847-657-8787
Practice Address - Fax:847-657-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010426261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care