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General NPI Number Information
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NPI Number | 1306185822
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Entity Type | Organization
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Legal Business Name | NOOR EYE CARE & ASSOCIATES S.C.
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 407 E 17TH ST
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City | LOMBARD
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State | IL
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Zip | 60148-4907
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Country | US
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Telephone | 630-340-8340
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Fax |
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Provider Business Mailing Address
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Address Line | 10 E 22ND ST SUITE 212
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City | LOMBARD
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State | IL
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Zip | 60148-4977
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Country | US
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Telephone | 630-495-8633
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Fax | 630-495-8643
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHJABEEN S HUSSAIN
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Credential | O.D.
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Telephone | 630-495-8633
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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 | 046008593
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License Number State | IL
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