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General NPI Number Information
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NPI Number | 1790054609
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Entity Type | Organization
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Legal Business Name | MIDWEST EYE, P.C.
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 2600 WARRENVILLE RD SUITE 211
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1761
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Country | US
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Telephone | 630-560-4730
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Fax | 630-560-4729
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Provider Business Mailing Address
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Address Line | 2600 WARRENVILLE RD SUITE 211
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1761
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Country | US
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Telephone | 630-560-4730
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Fax | 630-560-4729
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TODD A. ROBERT
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Credential |
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Telephone | 630-560-4730
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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 |
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