MEDICARE: EYECARE PARTNERS, LLC

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	152W00000X	Optometrist		IL

General Provider Information

NPI Number	:	1083722730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE PARTNERS, LLC

Provider Business Mailing Address
First Line	:	1135 HICKORY POINT MALL
Second Line	:
City	:	FORSYTH
State	:	IL
Zip	:	62535-2014
Country	:	US
Telephone Number	:	217-875-2622
Fax Number	:	217-875-2639

Provider Business Practice Location Address
First Line	:	1135 HICKORY POINT MALL
Second Line	:
City	:	FORSYTH
State	:	IL
Zip	:	62535-2014
Country	:	US
Telephone Number	:	217-875-2622
Fax Number	:	217-875-2639

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DENNIS M BRTVA
Credential	:	O.D
Telephone Number	:	217-875-2622

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/06/2023

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