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General NPI Number Information
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NPI Number | 1578731246
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Entity Type | Organization
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Legal Business Name | EYECARE CENTER OF DUPAGE, LTD.
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 6321 FAIRVIEW AVE STE A
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City | WESTMONT
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State | IL
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Zip | 60559-2886
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Country | US
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Telephone | 630-852-0102
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Fax | 630-852-0260
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Provider Business Mailing Address
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Address Line | 6425 DAVANE CT
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3057
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Country | US
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Telephone | 630-915-0157
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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. ANTHONY J. PRASNIKAR
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Credential | O.D.
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Telephone | 630-915-0157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 046-007544
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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 | 046-007544
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License Number State | IL
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