Provider Demographics
NPI:1851520233
Name:EYEGUYZ III, LTD
Entity Type:Organization
Organization Name:EYEGUYZ III, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL OPERATIONS, DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-514-3894
Mailing Address - Street 1:2305 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-7637
Mailing Address - Country:US
Mailing Address - Phone:847-832-9690
Mailing Address - Fax:847-832-9691
Practice Address - Street 1:2305 WILLOW RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7637
Practice Address - Country:US
Practice Address - Phone:847-832-9690
Practice Address - Fax:847-832-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6429320001Medicare NSC