Provider Demographics
NPI:1629185376
Name:GARY FINKELSTEIN MD EYE ASSOCIATES SC
Entity Type:Organization
Organization Name:GARY FINKELSTEIN MD EYE ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:FINKELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-672-4600
Mailing Address - Street 1:102 WEST ELM STREET
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364
Mailing Address - Country:US
Mailing Address - Phone:815-672-4600
Mailing Address - Fax:815-672-3333
Practice Address - Street 1:102 WEST ELM STREET
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364
Practice Address - Country:US
Practice Address - Phone:815-672-4600
Practice Address - Fax:815-672-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0420078OtherLICENSE NUMBER
IL209817Medicare PIN