Healthcare Provider Details

I. General information

NPI: 1962734129
Provider Name (Legal Business Name): BOYCE FAMILY EYE CARE, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 DEVON AVE
PARK RIDGE IL
60068-4820
US

IV. Provider business mailing address

528 DEVON AVE
PARK RIDGE IL
60068-4820
US

V. Phone/Fax

Practice location:
  • Phone: 847-518-0303
  • Fax:
Mailing address:
  • Phone: 847-518-0303
  • 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
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. PAMELA JUNE BOYCE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 847-518-0303