Provider Demographics
NPI:1730201443
Name:I CARE VISION CENTER INC
Entity type:Organization
Organization Name:I CARE VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KWAPIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-692-2020
Mailing Address - Street 1:10344 THOR DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8430
Mailing Address - Country:US
Mailing Address - Phone:989-692-2020
Mailing Address - Fax:989-692-2021
Practice Address - Street 1:10344 THOR DR
Practice Address - Street 2:SUITE B
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-8430
Practice Address - Country:US
Practice Address - Phone:989-692-2020
Practice Address - Fax:989-692-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P48190Medicare PIN