Provider Demographics
NPI:1851827273
Name:ICARE4VISION LLC
Entity Type:Organization
Organization Name:ICARE4VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CEPYNSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-665-6560
Mailing Address - Street 1:1231 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8809
Mailing Address - Country:US
Mailing Address - Phone:630-665-6560
Mailing Address - Fax:630-665-8760
Practice Address - Street 1:1231 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-8809
Practice Address - Country:US
Practice Address - Phone:630-665-6560
Practice Address - Fax:630-665-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007880152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty