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General NPI Number Information
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NPI Number | 1144325358
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Entity Type | Organization
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Legal Business Name | THE EYE CARE CENTER, LTD.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 8525 S HARLEM AVE
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City | BURBANK
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State | IL
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Zip | 60459-2293
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Country | US
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Telephone | 708-599-0050
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Fax | 708-599-1099
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Provider Business Mailing Address
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Address Line | 8525 S HARLEM AVE
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City | BURBANK
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State | IL
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Zip | 60459-2293
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Country | US
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Telephone | 708-599-0050
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Fax | 708-599-1099
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Authorized Official
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Title or Position | ASSOCIATE
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Name | DR. DONNA G. CARVER
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Credential | DO
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Telephone | 708-599-0050
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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 | 046-009852
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009577
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 046006541
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License Number State | IL
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