Provider Demographics
NPI:1932186657
Name:SCHWARTZ EYE CARE, INC.
Entity Type:Organization
Organization Name:SCHWARTZ EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-421-5870
Mailing Address - Street 1:749 N ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5655
Mailing Address - Country:US
Mailing Address - Phone:312-421-5870
Mailing Address - Fax:312-421-5910
Practice Address - Street 1:749 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5655
Practice Address - Country:US
Practice Address - Phone:312-421-5870
Practice Address - Fax:312-421-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006707152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046006707Medicaid
IL046006707Medicaid
ILL74651Medicare UPIN
IL0492410001Medicare ID - Type UnspecifiedADMINASTAR