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General NPI Number Information
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NPI Number | 1013099670
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Entity Type | Organization
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Legal Business Name | NAPERVILLE EYE ASSOCIATES LTD
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 1855 BAY SCOTT CIR
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City | NAPERVILLE
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State | IL
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Zip | 60540-1104
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Country | US
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Telephone | 630-357-5280
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Fax | 630-357-5367
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Provider Business Mailing Address
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Address Line | 1855 BAY SCOTT CIR
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City | NAPERVILLE
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State | IL
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Zip | 60540-1104
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Country | US
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Telephone | 630-357-5280
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Fax | 630-357-5367
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JEFF NICHOLS
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Credential |
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Telephone | 630-357-5280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036-041747
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License Number State | IL
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