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Organization
EYES OF GRACE SC
Active
Organization
EYES OF GRACE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE BAI MD (PHYSICIAN)
(847) 933-0800
Entity
Organization
Contact information
Practice address
9669 KENTON AVE STE 409, SKOKIE, IL 60076-1267
(847) 933-0800
(855) 329-4224
Mailing address
PO BOX 5178, SKOKIE, IL 60076-5178
(847) 933-3555
(847) 933-3559
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633731
BS OF IL
IL
05
—
036103366
—
IL
Enumeration date
07/31/2006
Last updated
11/12/2019
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