Healthcare Provider Details

I. General information

NPI: 1306966338
Provider Name (Legal Business Name): PANTON EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 W NORTH AVE
ELMWOOD PARK IL
60707-4124
US

IV. Provider business mailing address

7740 W NORTH AVE
ELMWOOD PARK IL
60707-4124
US

V. Phone/Fax

Practice location:
  • Phone: 708-452-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: PETER PANTON
Title or Position: OWNER
Credential: M.D.
Phone: 708-452-7200