Provider Demographics
NPI:1942408034
Name:JOSEPH UYEDA OD PC
Entity Type:Organization
Organization Name:JOSEPH UYEDA OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:UYEDA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-677-8022
Mailing Address - Street 1:4349 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3755
Mailing Address - Country:US
Mailing Address - Phone:847-677-8022
Mailing Address - Fax:847-677-8029
Practice Address - Street 1:4349 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3755
Practice Address - Country:US
Practice Address - Phone:847-677-8022
Practice Address - Fax:847-677-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008204152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1136060001Medicare NSC
ILU12360Medicare UPIN
IL208705Medicare PIN