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General NPI Number Information
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NPI Number | 1891104428
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Entity Type | Organization
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Legal Business Name | ADAS FAMILY EYECARE INC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 2656 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2019
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Country | US
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Telephone | 773-862-0743
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Fax | 773-862-0893
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Provider Business Mailing Address
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Address Line | 2656 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2019
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Country | US
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Telephone | 773-862-0743
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Fax | 773-862-0893
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MAGDALENA ADAS
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Credential | OD
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Telephone | 847-414-5999
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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 | 046009914
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License Number State | IL
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