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Organization
MIDWEST EYE CENTER
Active
Organization
MIDWEST EYE CENTER
Active
Other names
Midwest Eye Center, S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE L NEAL (CHIEF EXECUTIVE OFFICER)
(469) 214-0144
Entity
Organization
Contact information
Practice address
1700 E WEST RD, CALUMET CITY, IL 60409-5415
(708) 891-3330
(708) 891-0904
Mailing address
1700 E WEST RD, CALUMET CITY, IL 60409-5415
(708) 891-3330
(708) 891-0904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141037
MEDICARE FACILITY
IL
05
—
7001399
—
IL
01
—
CN5008
RAILROAD MEDICARE
IL
Enumeration date
03/31/2006
Last updated
02/05/2020
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