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General NPI Number Information
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NPI Number | 1841550761
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Entity Type | Organization
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Legal Business Name | RASA EYECARE & VISION GROUP INC
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 4700 135TH ST
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City | CRESTWOOD
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State | IL
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Zip | 60418-1405
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Country | US
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Telephone | 708-489-6951
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Fax | 708-489-8012
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Provider Business Mailing Address
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Address Line | 2551 75TH ST
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City | DARIEN
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State | IL
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Zip | 60561-4301
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Country | US
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Telephone | 708-489-6951
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Fax | 708-489-8012
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Authorized Official
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Title or Position | OWNER
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Name | RASA THARP
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Credential |
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Telephone | 630-528-0808
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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 | 046010144
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License Number State | IL
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