Healthcare Provider Details

I. General information

NPI: 1891356077
Provider Name (Legal Business Name): SNYDER EYE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22401 CENTRAL AVE
RICHTON PARK IL
60471-2062
US

IV. Provider business mailing address

234 LINCOLNSHIRE LN
BOLINGBROOK IL
60440-1921
US

V. Phone/Fax

Practice location:
  • Phone: 708-898-9994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE SNYDER
Title or Position: OPTOMETRIST/CEO
Credential: O.D.
Phone: 708-265-1957