Provider Demographics
NPI:1992833008
Name:SOUTHWEST EYE CENTER, S.C.
Entity Type:Organization
Organization Name:SOUTHWEST EYE CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BHAGVANJI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGHPARA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:708-799-9490
Mailing Address - Street 1:3330 W 177TH ST
Mailing Address - Street 2:UNIT 1 B
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2185
Mailing Address - Country:US
Mailing Address - Phone:708-799-9490
Mailing Address - Fax:708-799-9773
Practice Address - Street 1:3330 W 177TH ST
Practice Address - Street 2:UNIT 1 B
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2185
Practice Address - Country:US
Practice Address - Phone:708-799-9490
Practice Address - Fax:708-799-9773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
212816Medicare ID - Type Unspecified