MEDICARE: QUALITY EYE CARE CLINIC 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	046-009959	IL

General Provider Information

NPI Number	:	1386800316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY EYE CARE CLINIC LTD

Provider Business Mailing Address
First Line	:	502 WAVERLY DR
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-4082
Country	:	US
Telephone Number	:	708-692-6174
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 WAVERLY DRIVE
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-1392
Country	:	US
Telephone Number	:	847-697-7771
Fax Number	:	847-393-8153

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANAL HAJALI
Credential	:	OD
Telephone Number	:	708-692-6174

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	12/18/2014

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