Provider Demographics
NPI:1891248548
Name:SMART EYES LLC
Entity Type:Organization
Organization Name:SMART EYES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-287-7766
Mailing Address - Street 1:3150 N AURORA RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-3800
Mailing Address - Country:US
Mailing Address - Phone:630-340-4530
Mailing Address - Fax:630-701-2564
Practice Address - Street 1:3150 N AURORA RD
Practice Address - Street 2:SUITE I
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-3800
Practice Address - Country:US
Practice Address - Phone:630-340-4530
Practice Address - Fax:630-701-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046010163Medicaid
IL1194952598OtherGROUP MEDICARE