Healthcare Provider Details
I. General information
NPI: 1043330418
Provider Name (Legal Business Name): ATKINSON EYE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2007
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 N. HUNTINGTON DRIVE, UNIT A
ALGONQUIN IL
60102-5940
US
IV. Provider business mailing address
2100 N. HUNTINGTON DRIVE, UNIT A
ALGONQUIN IL
60102-5940
US
V. Phone/Fax
- Phone: 847-854-5700
- Fax: 847-854-5762
- Phone: 847-854-5700
- Fax: 847-854-5762
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELIZABETH
M.
ATKINSON
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 847-854-5700