Healthcare Provider Details

I. General information

NPI: 1144527417
Provider Name (Legal Business Name): PRECISION EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S MAIN ST
ALGONQUIN IL
60102-2628
US

IV. Provider business mailing address

204 S MAIN ST
ALGONQUIN IL
60102-2628
US

V. Phone/Fax

Practice location:
  • Phone: 224-678-9043
  • Fax:
Mailing address:
  • Phone: 224-678-9043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046009952
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046010058
License Number StateIL

VIII. Authorized Official

Name: JOSEPH B MORFOOT
Title or Position: MANAGER
Credential:
Phone: 224-678-9043