Provider Demographics
NPI:1831378090
Name:JAMES HUGHES,OD AND ASSOCIATES
Entity type:Organization
Organization Name:JAMES HUGHES,OD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-403-7895
Mailing Address - Street 1:14706 S LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3227
Mailing Address - Country:US
Mailing Address - Phone:708-403-7895
Mailing Address - Fax:
Practice Address - Street 1:14706 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3227
Practice Address - Country:US
Practice Address - Phone:708-403-7895
Practice Address - Fax:708-403-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211773Medicare PIN
ILT92358Medicare UPIN
ILK18097Medicare PIN