# EYES OF GRACE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043225535
- **Authorized official:** GRACE BAI MD (PHYSICIAN)
- **Authorized official phone:** (847) 933-0800

## Contact information

- **Practice address:** 9669 KENTON AVE STE 409, SKOKIE, IL 60076-1267
- **Practice address phone:** (847) 933-0800
- **Practice address fax:** (855) 329-4224
- **Mailing address:** PO BOX 5178, SKOKIE, IL 60076-5178
- **Mailing address phone:** (847) 933-3555
- **Mailing address fax:** (847) 933-3559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 11/12/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01633731 | BS OF IL | IL |
| 05 | — | 036103366 | — | IL |