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General NPI Number Information
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NPI Number | 1538242136
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Entity Type | Organization
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Legal Business Name | IDEAL FAMILY EYE CARE LTD
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 5526 N MILWAUKEE AVE UNIT B
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City | CHICAGO
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State | IL
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Zip | 60630-1227
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Country | US
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Telephone | 773-774-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 5526 N MILWAUKEE AVE UNIT B
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City | CHICAGO
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State | IL
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Zip | 60630-1227
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Country | US
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Telephone | 773-774-2200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SYLWIA DOMINIKA SZEWCZYK
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Credential | O.D
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Telephone | 773-206-0130
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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 |
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License Number State | IL
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