Provider Demographics
NPI:1861766651
Name:LOOK EYE CARE AND EYE WEAR, LLC
Entity type:Organization
Organization Name:LOOK EYE CARE AND EYE WEAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-360-2393
Mailing Address - Street 1:1048 104TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5118
Mailing Address - Country:US
Mailing Address - Phone:630-360-2393
Mailing Address - Fax:630-560-4919
Practice Address - Street 1:1048 104TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5118
Practice Address - Country:US
Practice Address - Phone:630-360-2393
Practice Address - Fax:630-560-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL046010211152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty