Provider Demographics
NPI:1790881985
Name:VISIONARY EYE CARE PROFESSIONALS PC
Entity Type:Organization
Organization Name:VISIONARY EYE CARE PROFESSIONALS PC
Other - Org Name:VISIONARY EYE CARE PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CIZSEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-201-8989
Mailing Address - Street 1:181 W MADISON ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-4510
Mailing Address - Country:US
Mailing Address - Phone:312-201-8989
Mailing Address - Fax:301-201-8984
Practice Address - Street 1:181 W MADISON ST
Practice Address - Street 2:SUITE 125
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4510
Practice Address - Country:US
Practice Address - Phone:312-201-8989
Practice Address - Fax:301-201-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3666-7056152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty