Crystal Clear Eye Care Clinic
Preferred Provider Organization in Schaumberg, IL. Organization (NPI-2).
NPI number1154552016
StatusActive
Last updated in NPPESAug 26, 2010
Details
- NPI
- 1154552016
- Entity type
- Organization (NPI-2)
- Legal business name
- Crystal Clear Eye Care Clinic
- Organization subpart
- No
- Enumeration date
- Jul 27, 2009
- Last updated
- Aug 26, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 046007080 | IL | Yes |
| 305R00000X | Preferred Provider Organization | 047935456 | IL |
Practice location
1760 WiseSchaumberg, IL 60193
Phone 847-524-1700 · Fax 847-524-1702
Mailing address
1760 WiseSchaumberg, IL 60193
Phone 847-524-1700 · Fax 847-524-1702
Authorized official
Sherry L Bakovich
Office Manger
8475241700
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