MEDICARE: CARR EYE PROFESSIONALS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist
2	207W00000X	Ophthalmology Physician
3	152W00000X	Optometrist	060-007090	IL

General Provider Information

NPI Number	:	1396866323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARR EYE PROFESSIONALS PC

Provider Business Mailing Address
First Line	:	9661 W 143RD ST STE 202
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-2088
Country	:	US
Telephone Number	:	708-361-6141
Fax Number	:	708-361-5327

Provider Business Practice Location Address
First Line	:	9661 W 143RD ST STE 202
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-2088
Country	:	US
Telephone Number	:	708-361-6141
Fax Number	:	708-361-5327

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONALD CARR
Credential	:	O.D.
Telephone Number	:	708-361-6141

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/19/2022

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Directions to “CARR EYE PROFESSIONALS PC ” Practice Location

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