Provider Demographics
NPI:1295074425
Name:WINK EYECARE PC
Entity type:Organization
Organization Name:WINK EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:TWEED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-220-3900
Mailing Address - Street 1:121 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-4347
Mailing Address - Country:US
Mailing Address - Phone:773-220-3900
Mailing Address - Fax:
Practice Address - Street 1:2300 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2067
Practice Address - Country:US
Practice Address - Phone:815-758-3825
Practice Address - Fax:815-758-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009432152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty