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General NPI Number Information
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NPI Number | 1144527417
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Entity Type | Organization
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Legal Business Name | PRECISION EYE CARE LLC
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 204 S MAIN ST
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City | ALGONQUIN
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State | IL
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Zip | 60102-2628
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Country | US
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Telephone | 224-678-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 204 S MAIN ST
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City | ALGONQUIN
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State | IL
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Zip | 60102-2628
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Country | US
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Telephone | 224-678-9043
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOSEPH B MORFOOT
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Credential |
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Telephone | 224-678-9043
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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 | 046009952
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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 | 046010058
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License Number State | IL
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