Provider Demographics
NPI:1588850648
Name:GURNEE EYE CARE, P.C.
Entity Type:Organization
Organization Name:GURNEE EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONGI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-623-3937
Mailing Address - Street 1:312 TRI STATE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5283
Mailing Address - Country:US
Mailing Address - Phone:847-623-3937
Mailing Address - Fax:
Practice Address - Street 1:312 TRI STATE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5283
Practice Address - Country:US
Practice Address - Phone:847-623-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208248OtherMEDICARE GROUP NUMBER
IL4923647OtherBLUE SHIELD PROVIDER NUM
ILP00259509OtherMEDICARE RAILROAD PIN
IL4932533OtherBLUE SHIELD PROVIDER NUM
ILT38730Medicare UPIN
ILP00259509OtherMEDICARE RAILROAD PIN
IL208248OtherMEDICARE GROUP NUMBER