Provider Demographics
NPI:1720202559
Name:EYE CARE CENTER OF LAKE COUNTY, LTD
Entity Type:Organization
Organization Name:EYE CARE CENTER OF LAKE COUNTY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER& PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:REINGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-244-1657
Mailing Address - Street 1:6 E PHILLIP RD
Mailing Address - Street 2:SUITE 1110
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1700
Mailing Address - Country:US
Mailing Address - Phone:847-816-9996
Mailing Address - Fax:847-816-3142
Practice Address - Street 1:310 S GREENLEAF ST
Practice Address - Street 2:SUITE 209
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5708
Practice Address - Country:US
Practice Address - Phone:847-244-1657
Practice Address - Fax:847-244-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04915265OtherBLUE CROSS - BLUE SHIELD
IL0448750003Medicare NSC
0448750001Medicare PIN