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NPI Code Detail

MEDICARE: THE EYE SPECIALISTS CENTER, L.L.C.

MEDICARE: THE EYE SPECIALISTS CENTER, L.L.C.
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
1156FX1202XOptometric TechnicianIL
2207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134481211OTHERILNPI BIRVA KADAKIA, OD
21437323896OTHERILNPI ROSHNI VASAIWALA, MD
31477522050OTHERILNPI JONATHAN S BUKA, MD
41659412682OTHERILNPI HASSAN SHAH, MD
51881759694OTHERILNPI KARL TICHO, MD
61649256512OTHERILNPI ALEXANDER J KHAMMAR, MD
71306045083OTHERILNPI MEGAN ALLEN, OD
81770544462OTHERILNPI EMMET MICHAEL CASSIDY
91992782494OTHERILNPI BEN TICHO, MD

General Provider Information

NPI Number : 1699802421
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE EYE SPECIALISTS CENTER, L.L.C.
Provider Business Mailing Address
First Line : DEPARTMENT 4684
Second Line :
City : CAROL STREAM
State : IL
Zip : 60122-4684
Country : US
Telephone Number : 708-952-0109
Fax Number : 708-952-0329
Provider Business Practice Location Address
First Line : 10436 SOUTHWEST HWY
Second Line :
City : CHICAGO RIDGE
State : IL
Zip : 60415-2282
Country : US
Telephone Number : 708-423-4070
Fax Number : 708-423-4216
Authorized Official
Title or Position : OWNER/PARTNER/PHYSICIAN
Name : DR. BENJAMIN HENDRICK TICHO
Credential : M.D.
Telephone Number : 708-423-4070
Provider Enumeration Date : 02/28/2007
Last Update Date : 04/30/2013

Similar Medicare Providers

1992782494 — BENJAMIN HENDRICK TICHO MD
Practice Location Address:
10436 SOUTHWEST HIGHWAY
CHICAGO RIDGE, IL
60415-2282
Practice Phone: 708-423-4070
Practice Fax: 708-423-4216
1083684922 — THE EYE SPECIALISTS CENTER LLC
Practice Location Address:
10436 SOUTHWEST HWY
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Practice Phone: 708-423-4070
Practice Fax: 708-423-4216
1124124409 — DARIN STRAKO OD
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10436 SOUTHWEST HWY STE 101
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Practice Phone: 85-864-9227
Practice Fax: 708-423-4216
1700932373 — DR. CHRISTINE D BOYD M.D.
Practice Location Address:
10436 SOUTHWEST HWY
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60415-2282
Practice Phone: 708-636-0700
Practice Fax: 708-636-3849
1194865287 — PEDIATRIC HEALTH PARTNERS, S.C.
Practice Location Address:
10436 SOUTHWEST HWY
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60415-2282
Practice Phone: 708-636-0700
Practice Fax: 708-636-3849
1134481211 — BIRVA K SHAH O.D.
Practice Location Address:
10436 SOUTHWEST HWY , SUITE 101
CHICAGO RIDGE, IL
60415-2282
Practice Phone: 708-423-4192
Practice Fax: 708-952-0329

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