Provider Demographics
NPI:1689726903
Name:UNIVERSITY OPHTHALMOLOGY ASSOCIATES, LTD
Entity Type:Organization
Organization Name:UNIVERSITY OPHTHALMOLOGY ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-942-2734
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 918
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-942-2734
Mailing Address - Fax:312-942-2156
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 918
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-2734
Practice Address - Fax:312-942-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1608654OtherBLUE CROSS BLUE SHIELD
IL769360Medicare ID - Type Unspecified