Provider Demographics
NPI:1144325358
Name:THE EYE CARE CENTER, LTD.
Entity type:Organization
Organization Name:THE EYE CARE CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:708-599-0050
Mailing Address - Street 1:8525 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-2293
Mailing Address - Country:US
Mailing Address - Phone:708-599-0050
Mailing Address - Fax:708-599-1099
Practice Address - Street 1:8525 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2293
Practice Address - Country:US
Practice Address - Phone:708-599-0050
Practice Address - Fax:708-599-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009852152W00000X
IL046-009577152W00000X
261QM2500X
IL046006541332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37302Medicare UPIN
ILIL4528Medicare PIN
IL0303930001Medicare NSC