Provider Demographics
NPI:1780862540
Name:LORENZANA, SC
Entity Type:Organization
Organization Name:LORENZANA, SC
Other - Org Name:ADVANCED VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRYD
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZANA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-837-3939
Mailing Address - Street 1:19 E SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3503
Mailing Address - Country:US
Mailing Address - Phone:847-891-8003
Mailing Address - Fax:847-891-8045
Practice Address - Street 1:2 EXECUTIVE CT STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9507
Practice Address - Country:US
Practice Address - Phone:847-891-8003
Practice Address - Fax:847-891-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008743261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046008743Medicaid
IL211328Medicare PIN