Provider Demographics
NPI:1609140409
Name:CENTRAL EYE CARE LTD
Entity Type:Organization
Organization Name:CENTRAL EYE CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:YONAN
Authorized Official - Last Name:BADAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-735-2016
Mailing Address - Street 1:133 MICHAEL MNR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4629
Mailing Address - Country:US
Mailing Address - Phone:847-877-4288
Mailing Address - Fax:800-878-6832
Practice Address - Street 1:1614 W CENTRAL RD
Practice Address - Street 2:SUITE 107
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2490
Practice Address - Country:US
Practice Address - Phone:224-735-2016
Practice Address - Fax:800-878-6832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036102073207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH29498Medicare UPIN