Provider Demographics
NPI:1548386360
Name:PRIMARY EYE CARE, LTD.
Entity Type:Organization
Organization Name:PRIMARY EYE CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MURPHY
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-837-8300
Mailing Address - Street 1:75 S SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-3367
Mailing Address - Country:US
Mailing Address - Phone:630-837-8300
Mailing Address - Fax:630-837-9146
Practice Address - Street 1:75 S SUTTON RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-3367
Practice Address - Country:US
Practice Address - Phone:630-837-8300
Practice Address - Fax:630-837-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0467360001OtherADMINISTAR FEDERAL DME B
0467360001OtherADMINISTAR FEDERAL DME B