Provider Demographics
NPI:1598019440
Name:NORTH SHORE EYE CONSULTANTS LTD
Entity Type:Organization
Organization Name:NORTH SHORE EYE CONSULTANTS LTD
Other - Org Name:AMY CUNNINGHAM MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-724-9400
Mailing Address - Street 1:2440 RAVINE WAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-7647
Mailing Address - Country:US
Mailing Address - Phone:847-724-9400
Mailing Address - Fax:847-724-9401
Practice Address - Street 1:2440 RAVINE WAY
Practice Address - Street 2:SUITE 500
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7647
Practice Address - Country:US
Practice Address - Phone:847-724-9400
Practice Address - Fax:847-724-9401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH SHORE EYE CONSULTANTS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty