Healthcare Provider Details

I. General information

NPI: 1821129834
Provider Name (Legal Business Name): ARBOR CENTER FOR EYECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 WEST 183RD ST
HOMEWOOD IL
60430
US

IV. Provider business mailing address

2640 WEST 183RD STREET
HOMEWOOD IL
60430
US

V. Phone/Fax

Practice location:
  • Phone: 708-798-6633
  • Fax: 708-798-4486
Mailing address:
  • Phone: 708-798-6633
  • Fax: 708-798-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. CHRISTINE GLENN
Title or Position: OPTICAL MANAGER
Credential: ABOC
Phone: 708-798-6633