Provider Demographics
NPI:1902188741
Name:SILVESTRE EYE CARE, P.C.
Entity Type:Organization
Organization Name:SILVESTRE EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ELAINE
Authorized Official - Middle Name:HERNANDEZ
Authorized Official - Last Name:SILVESTRE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-701-5252
Mailing Address - Street 1:8661 N. ELMORE ST.
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1910
Mailing Address - Country:US
Mailing Address - Phone:847-701-5252
Mailing Address - Fax:847-966-0578
Practice Address - Street 1:6023 W. BELMONT AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-5116
Practice Address - Country:US
Practice Address - Phone:773-237-4332
Practice Address - Fax:773-237-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009931302R00000X
IL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL7353Medicare PIN