Provider Demographics
NPI:1205961620
Name:EYE CARE CENTERS OF CHICAGO, INC.
Entity type:Organization
Organization Name:EYE CARE CENTERS OF CHICAGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-432-0080
Mailing Address - Street 1:940 W ADAMS ST STE 302
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3004
Mailing Address - Country:US
Mailing Address - Phone:312-432-0080
Mailing Address - Fax:312-432-0586
Practice Address - Street 1:940 W ADAMS ST STE 302
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3004
Practice Address - Country:US
Practice Address - Phone:312-432-0080
Practice Address - Fax:312-432-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty