Healthcare Provider Details

I. General information

NPI: 1902188741
Provider Name (Legal Business Name): SILVESTRE EYE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2011
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6023 W. BELMONT AVE.
CHICAGO IL
60634-5116
US

IV. Provider business mailing address

8661 N. ELMORE ST.
NILES IL
60714-1910
US

V. Phone/Fax

Practice location:
  • Phone: 773-237-4332
  • Fax: 773-237-5779
Mailing address:
  • Phone: 847-701-5252
  • Fax: 847-966-0578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number046.009931
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. MARY ELAINE HERNANDEZ SILVESTRE
Title or Position: OPTOMETRIST/PRESIDENT
Credential: O.D.
Phone: 847-701-5252