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NPI Code Detail

MEDICARE: VISIONARY EYE CARE PROFESSIONALS PC

MEDICARE: VISIONARY EYE CARE PROFESSIONALS PC
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
1152W00000XOptometrist3666-7056IL

General Provider Information

NPI Number : 1790881985
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISIONARY EYE CARE PROFESSIONALS PC
Provider Business Mailing Address
First Line : 181 W MADISON ST
Second Line : SUITE 125
City : CHICAGO
State : IL
Zip : 60602-4510
Country : US
Telephone Number : 312-201-8989
Fax Number : 301-201-8984
Provider Business Practice Location Address
First Line : 181 W MADISON ST
Second Line : SUITE 125
City : CHICAGO
State : IL
Zip : 60602-4510
Country : US
Telephone Number : 312-201-8989
Fax Number : 301-201-8984
Authorized Official
Title or Position : CO-OWNER
Name : DR. MICHAEL CIZSEK
Credential : OD
Telephone Number : 312-201-8989
Provider Enumeration Date : 09/15/2006
Last Update Date : 01/26/2017

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Directions to “VISIONARY EYE CARE PROFESSIONALS PC ” Practice Location

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