Provider Demographics
NPI:1912478462
Name:CHICAGOLAND EYECARE INC
Entity Type:Organization
Organization Name:CHICAGOLAND EYECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROITSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-325-2020
Mailing Address - Street 1:890 WILLIAM HILTON PKWY STE 93
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3419
Mailing Address - Country:US
Mailing Address - Phone:184-368-1202
Mailing Address - Fax:
Practice Address - Street 1:890 WILLIAM HILTON PKWY STE 93
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3419
Practice Address - Country:US
Practice Address - Phone:843-681-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHICAGOLAND EYECARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty