Healthcare Provider Details

I. General information

NPI: 1174584270
Provider Name (Legal Business Name): GENEVA EYE CLINIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 RANDALL RD STE 100
GENEVA IL
60134-2591
US

IV. Provider business mailing address

1000 RANDALL RD STE 100
GENEVA IL
60134-2591
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-1282
  • Fax: 630-232-7011
Mailing address:
  • Phone: 630-232-1282
  • Fax: 630-232-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANJALI S HAWKINS
Title or Position: OWNER
Credential: MD
Phone: 630-232-1282