Provider Demographics
NPI:1568042463
Name:STONEVIEW EYE CARE, LLC
Entity Type:Organization
Organization Name:STONEVIEW EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-242-9886
Mailing Address - Street 1:4775 E ROCKTON RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-9076
Mailing Address - Country:US
Mailing Address - Phone:815-242-9886
Mailing Address - Fax:815-242-9809
Practice Address - Street 1:4775 E ROCKTON RD UNIT A
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-9076
Practice Address - Country:US
Practice Address - Phone:815-242-9886
Practice Address - Fax:815-242-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty