# THE EYE SPECIALISTS CENTER LLC

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

## Provider details

- **NPI number:** 1083684922
- **Authorized official:** DR. JONATHAN S BUKA M.D. (OWNER/PARTNER/PHYSICIAN)
- **Authorized official phone:** (708) 423-4070

## Contact information

- **Practice address:** 10436 SOUTHWEST HWY, CHICAGO RIDGE, IL 60415-2282
- **Practice address phone:** (708) 423-4070
- **Practice address fax:** (708) 423-4216
- **Mailing address:** DEPARTMENT 4684, CAROL STREAM, IL 60122-4684
- **Mailing address phone:** (708) 952-0329
- **Mailing address fax:** (708) 952-0329

## Taxonomy

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

## Other

- **Enumeration date:** 01/24/2006
- **Last updated:** 01/23/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01620861 | BLUE CROSS AND BLUE SHEILD OF ILLINOIS | IL |
| 05 | — | 036123095 | — | IL |
| 05 | — | 036126041 | — | IL |
| 01 | — | 036128553 | PHYSICIANS LICENSE | IL |
| 05 | — | 036128553 | — | IL |
| 01 | — | 046009799 | LICENSE NO | IL |
| 05 | — | 047935428 | — | IL |
| 05 | — | 047935429 | — | IL |
| 01 | — | 12324832 | CAQH R. VASAIWALA, MD | IL |
| 01 | — | 1306045083 | INDIVIDUAL NPI | IL |
| 01 | — | 1386637791 | INDIVIDUAL NPI | IL |
| 01 | — | 1477522050 | NPI INDIVIDUAL JONATHAN S BUKA, MD | IL |
| 01 | — | 1477522050 | NPI INDIVIDUAL JONATHAN S BUKA, MD | IN |
| 01 | — | 1649256512 | NPI INDIVIDUAL ALEXANDER J KHAMMAR, MD | IL |
| 01 | — | 1649256512 | NPI INDIVIDUAL ALEXANDER J KHAMMAR, MD | IN |
| 01 | — | 1659412682 | NPI IDIVIDUAL HASSAN SHAH, MD | IL |
| 01 | — | 1659412682 | NPI INDIVIDUAL HASSAN A SHAH, MD | IN |
| 01 | — | 1679551014 | NPI INDIVIDUAL | IL |
| 01 | — | 1689988446 | NPI INDIVIDUAL CHRISTINA M TWARDOWSKI, OD | IL |
| 01 | — | 1699802421 | OPTICAL NPI THE EYE SPECIALISTS CENTER | IL |
| 01 | — | 1700047222 | NPI DR SHIFRIN | IL |
| 01 | — | 1700047222 | NPI INDIVIDUAL KABITA S SHIFRIN, DO | IN |
| 01 | — | 1770544462 | NPI INDIVIDUAL EMMET M. CASSIDY, MD | IL |
| 01 | — | 180046208 | MEDICARE RAILROAD | IL |
| 01 | — | 180046209 | MEDICARE RAILROAD | IL |
| 01 | — | 180046210 | MEDICARE RAILROAD | IL |
| 01 | — | 180046211 | MEDICARE RAILROAD | IL |
| 01 | — | 180046212 | MEDICARE RAILROAD | IL |
| 01 | — | 1881759694 | NPI INDIVIDUAL KARL TICHO, MD | IL |
| 01 | — | 1992782494 | NPI INDIVIDUAL BENJAMIN H TICHO | IL |
| 01 | — | 200871680A | MEDICAID LOCATION MUNSTER | IN |
| 01 | — | 200871680B | MEDICAID LOCATION CHICAGO RIDGE | IN |
| 01 | — | 200871680C | MEDICAID LOCATION ORLAND PARK | IN |
| 01 | — | 200871680D | MEDICAID LOCATION HINSDALE | IN |
| 01 | — | 205785 | PTAN IL MEDICARE COOK COUNTY | IL |
| 01 | — | 205786 | PTAN IL MEDICARE DUPAGE COUNTY | IL |
| 01 | — | 253350 | PTAN INDIANA MEDICARE GROUP | IN |
| 01 | — | 60180260001 | DEMERC SUPPLIER PTAN | IL |
| 01 | — | CK7818 | MEDICARE RAILROAD GRP PTAN | IL |
| 01 | — | P00638025 | MEDICARE RAILROAD | IL |
| 01 | — | PTAN P00638025 | RAILROAD MEDICARE | IL |