Provider Demographics
NPI:1679582845
Name:HOUR EYE CARE, LLC
Entity Type:Organization
Organization Name:HOUR EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLATCHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-623-3937
Mailing Address - Street 1:5003 HONONEGAH RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-8645
Mailing Address - Country:US
Mailing Address - Phone:815-623-3937
Mailing Address - Fax:815-623-8298
Practice Address - Street 1:5003 HONONEGAH RD STE 1
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-8645
Practice Address - Country:US
Practice Address - Phone:815-544-9865
Practice Address - Fax:815-623-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009012152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
213526Medicare PIN
5771410001Medicare NSC
U67543Medicare UPIN