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General NPI Number Information
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NPI Number | 1215203260
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Entity Type | Organization
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Legal Business Name | FARNSWORTH EYE CARE, PC
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 535 FAIRWAY DR STE 127
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City | NAPERVILLE
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State | IL
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Zip | 60563-3940
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Country | US
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Telephone | 630-428-3937
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Fax | 630-428-8590
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Provider Business Mailing Address
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Address Line | 535 FAIRWAY DR STE 127
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City | NAPERVILLE
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State | IL
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Zip | 60563-3940
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Country | US
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Telephone | 630-428-3937
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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. FRANK VERGARA
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Credential | O.D.
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Telephone | 630-428-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 046007847
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License Number State | IL
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