Provider Demographics
NPI:1558418525
Name:OPHTHALMOLOGY ASSOCIATES LTD
Entity Type:Organization
Organization Name:OPHTHALMOLOGY ASSOCIATES LTD
Other - Org Name:SEIGLE-ACKERMANN EYE ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-888-2020
Mailing Address - Street 1:1670 CAPITAL STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124
Mailing Address - Country:US
Mailing Address - Phone:847-888-2020
Mailing Address - Fax:847-888-0652
Practice Address - Street 1:1670 CAPITAL STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124
Practice Address - Country:US
Practice Address - Phone:847-888-2020
Practice Address - Fax:847-888-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004500697OtherBLUE CROSS BLUE SHIELD IL
IL340850Medicare PIN
IL0004500697OtherBLUE CROSS BLUE SHIELD IL
ILCK5053Medicare PIN