Provider Demographics
NPI:1932325255
Name:WESTGROVE VISION CENTER LTD
Entity Type:Organization
Organization Name:WESTGROVE VISION CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:630-824-3800
Mailing Address - Street 1:134 OGDEN AVENUE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2322
Mailing Address - Country:US
Mailing Address - Phone:630-824-3800
Mailing Address - Fax:630-824-3820
Practice Address - Street 1:134 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2322
Practice Address - Country:US
Practice Address - Phone:630-824-3800
Practice Address - Fax:630-824-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00758252OtherINDIVIDUAL PTAN
ILIL1312OtherINDIVIDUAL P TAN NUMBER
ILIL1312001OtherGROUP PTAN NUMBER
ILDP4491OtherGROUP PTAN RAILROAD MEDICARE
ILDP4491OtherGROUP PTAN RAILROAD MEDICARE
ILU61254Medicare UPIN
ILP00758252Medicare PIN
ILP00758252OtherINDIVIDUAL PTAN