MEDICARE: EYES ON YOU, LTD

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004504795	OTHER	IL	BLUECROSSBLUESHIELD

General Provider Information

NPI Number	:	1356476295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES ON YOU, LTD

Provider Business Mailing Address
First Line	:	2010 W WILSON ST
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-9482
Country	:	US
Telephone Number	:	630-406-0606
Fax Number	:	630-406-0996

Provider Business Practice Location Address
First Line	:	2010 W WILSON ST
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-9482
Country	:	US
Telephone Number	:	630-406-0606
Fax Number	:	630-406-0996

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLES K ATWELL
Credential	:	O.D.
Telephone Number	:	630-406-0606

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/22/2020

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Directions to “EYES ON YOU, LTD ” Practice Location

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