MEDICARE: AESTHETIC EYE ASSOCIATES S.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	174400000X	Specialist	IL
2	207W00000X	Ophthalmology Physician	IL
3	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	IL

General Provider Information

NPI Number	:	1790980589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AESTHETIC EYE ASSOCIATES S.C.

Provider Business Mailing Address
First Line	:	619 FOREST AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-1713
Country	:	US
Telephone Number	:	847-728-0105
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 BIESTERFIELD RD STE 3006
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3364
Country	:	US
Telephone Number	:	877-898-3937
Fax Number	:	847-283-7658

Authorized Official
Title or Position	:	OWNER
Name	:	KATHLEEN G ALBRECHT
Credential	:
Telephone Number	:	847-728-0105

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	09/06/2023

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Directions to “AESTHETIC EYE ASSOCIATES S.C. ” Practice Location

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