Healthcare Provider Details

I. General information

NPI: 1629840608
Provider Name (Legal Business Name): EYE CARE AT HOME P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2254 DAWSON LN
ALGONQUIN IL
60102-5975
US

IV. Provider business mailing address

2254 DAWSON LN
ALGONQUIN IL
60102-5975
US

V. Phone/Fax

Practice location:
  • Phone: 847-927-2106
  • Fax: 847-854-5762
Mailing address:
  • Phone: 847-927-2106
  • Fax: 847-854-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM R ATKINSON
Title or Position: PRESIDENT
Credential: OD
Phone: 847-927-2106