MEDICARE: EYE SURGEONS SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician		IL

General Provider Information

NPI Number	:	1003949777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE SURGEONS SC

Provider Business Mailing Address
First Line	:	5330 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-775-4947
Fax Number	:	773-775-5109

Provider Business Practice Location Address
First Line	:	5330 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-775-4947
Fax Number	:	773-775-5109

Authorized Official
Title or Position	:	SECRETARY
Name	:	IRENE STOEPLER
Credential	:
Telephone Number	:	773-743-4300

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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Directions to “EYE SURGEONS SC ” Practice Location

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