Provider Demographics
NPI:1740319490
Name:EYE SURGEONS SC
Entity type:Organization
Organization Name:EYE SURGEONS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-743-4300
Mailing Address - Street 1:6801 N CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4512
Mailing Address - Country:US
Mailing Address - Phone:773-743-4300
Mailing Address - Fax:773-743-5132
Practice Address - Street 1:6801 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4512
Practice Address - Country:US
Practice Address - Phone:773-743-4300
Practice Address - Fax:773-743-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0850070001Medicare NSC