# KERATOCONUS SPECIALIST OF ILLINOIS LTD

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

## Provider details

- **NPI number:** 1043648439
- **Authorized official:** DR. STEVEN B EIDEN OD (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (847) 412-0311

## Contact information

- **Practice address:** 4 WESTBROOK CORPORATE CTR, SUITE 111, WESTCHESTER, IL 60154-5752
- **Practice address phone:** (708) 562-4682
- **Practice address fax:** (708) 562-4785
- **Mailing address:** 360 S WAUKEGAN RD, SUITE A, DEERFIELD, IL 60015-5653
- **Mailing address phone:** (847) 412-0315
- **Mailing address fax:** (847) 412-0316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WC0802X | Corneal and Contact Management Optometrist | 046007419 | IL | Yes |

## Other

- **Enumeration date:** 10/22/2013
- **Last updated:** 10/22/2013