NPI Code Detail JSON Logo

1205083383 NPI number — ENVISION EYE CENTER LTD

NPI Number: 1205083383
Health Care Provider/Practitioner: ENVISION EYE CENTER LTD

Information about “1205083383” NPI (ENVISION EYE CENTER LTD) exists in 1205083383 in HTML format HTML  |  1205083383 in plain Text format TXT  |  1205083383 in PDF (Portable Document Format) PDF  |  1205083383 in an XML format XML  formats.

NPI Number : 1205083383 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205083383",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ENVISION EYE CENTER LTD",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "900 N WESTMORELAND RD",
    "SecondLineMailingAddress": "SUITE LL84",
    "MailingAddressCityName": "LAKE FOREST",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60045-1681",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-295-0001",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "900 N WESTMORELAND RD",
    "SecondLinePracticeLocationAddress": "SUITE LL84",
    "PracticeLocationAddressCityName": "LAKE FOREST",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60045-1681",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-295-0001",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/20/2008",
    "LastUpdateDate": "12/23/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "RUFF",
    "AuthorizedOfficialFirstName": "BRADLEY",
    "AuthorizedOfficialMiddleName": "ETHAN",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "847-295-0001",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "332B00000X",
        "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
        "LicenseNumber": "036062774",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.