Healthcare Provider Details

I. General information

NPI: 1720922180
Provider Name (Legal Business Name): ELMHURST EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S SPRING RD
ELMHURST IL
60126-3824
US

IV. Provider business mailing address

430 N ADDISON AVE
ELMHURST IL
60126-2310
US

V. Phone/Fax

Practice location:
  • Phone: 773-350-7391
  • Fax:
Mailing address:
  • Phone: 773-350-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: MARSHA MALOOLEY
Title or Position: PRESIDENT
Credential: OD
Phone: 773-350-7391