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General NPI Number Information
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NPI Number | 1083661029
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Entity Type | Organization
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Legal Business Name | PRIMARY EYE CARE CENTERS, PC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 1603 N ALPINE RD ST 121
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City | ROCKFORD
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State | IL
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Zip | 61107-1439
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Country | US
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Telephone | 815-209-9420
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 N ALPINE RD ST 121
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City | ROCKFORD
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State | IL
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Zip | 61107-1439
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Country | US
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Telephone | 815-209-9420
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM C HILLMANN
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Credential | OD
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Telephone | 815-209-9420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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