Provider Demographics
NPI:1598825846
Name:DR. JAMES M SAUL & ASSOCIATES PC
Entity Type:Organization
Organization Name:DR. JAMES M SAUL & ASSOCIATES PC
Other - Org Name:DR. JAMES M. SAUL & ASSOC. PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-832-6783
Mailing Address - Street 1:25 S VILLA AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2650
Mailing Address - Country:US
Mailing Address - Phone:630-832-6783
Mailing Address - Fax:630-832-0495
Practice Address - Street 1:25 S VILLA AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2650
Practice Address - Country:US
Practice Address - Phone:630-832-6783
Practice Address - Fax:630-832-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007690152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL060004988OtherSTATE CORPORATE LICENSE N
IL913590Medicare UPIN
IL0298760001Medicare NSC
IL913590Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER