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NPI Code Detail

MEDICARE: DOWNERS GROVE EYE CENTER, PC

MEDICARE: DOWNERS GROVE EYE CENTER, 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
1152W00000XOptometrist046008708IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12234272OTHERILBCBS
21376550061OTHERINDIVIDUAL NPI AS EMPLOYE
31801997655OTHERILBCBS

General Provider Information

NPI Number : 1801997655
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOWNERS GROVE EYE CENTER, PC
Provider Business Mailing Address
First Line : 4958 FOREST AVE
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-3508
Country : US
Telephone Number : 630-737-1001
Fax Number : 630-737-1003
Provider Business Practice Location Address
First Line : 4958 FOREST AVE
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-3508
Country : US
Telephone Number : 630-737-1001
Fax Number : 630-737-1003
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL DONALD MACEK
Credential : OD
Telephone Number : 630-737-1001
Provider Enumeration Date : 09/26/2006
Last Update Date : 04/19/2016

Similar Medicare Providers

1720017643 — SOPHIA SARKOS MD
Practice Location Address:
4958 FOREST AVE
DOWNERS GROVE, IL
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1376550061 — MICHAEL D MACEK OD
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1386038719 — DR. KIMBERLY JEAN ESTES MD
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1194656728 — ESTES EYE CARE PLLC
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Directions to “DOWNERS GROVE EYE CENTER, PC ” Practice Location

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