Provider Demographics
NPI:1609878040
Name:STEINER, PATRICIA A (OD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:STEINER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENEVA EYE CLINIC LTD
Mailing Address - Street 2:302 RANDALL RD STE 10
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134
Mailing Address - Country:US
Mailing Address - Phone:630-232-7011
Mailing Address - Fax:630-232-7011
Practice Address - Street 1:GENEVA EYE CLINIC LTD
Practice Address - Street 2:302 RANDALL RD STE 10
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134
Practice Address - Country:US
Practice Address - Phone:630-232-1282
Practice Address - Fax:630-232-7011
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008186152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046008186Medicaid
IL577390Medicare ID - Type Unspecified
U12626Medicare UPIN
IL0244590001Medicare NSC