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NPI Code Detail

MEDICARE: SAUGANASH FAMILY EYE CENTER, LLC

MEDICARE: SAUGANASH FAMILY EYE CENTER, 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
1152W00000XOptometrist047932887IL

General Provider Information

NPI Number : 1801105697
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAUGANASH FAMILY EYE CENTER, LLC
Provider Business Mailing Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number : 773-685-6559
Provider Business Practice Location Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number : 773-685-6559
Authorized Official
Title or Position : CO-OWNER
Name : DR. STEPHEN P STEINMETZ
Credential : O.D.
Telephone Number : 773-685-5606
Provider Enumeration Date : 09/28/2010
Last Update Date : 11/15/2010

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Directions to “SAUGANASH FAMILY EYE CENTER, LLC ” Practice Location

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