# MIDWEST EYE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Eye Center, S.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790746428
- **Authorized official:** GEORGE L NEAL (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (469) 214-0144

## Contact information

- **Practice address:** 1700 E WEST RD, CALUMET CITY, IL 60409-5415
- **Practice address phone:** (708) 891-3330
- **Practice address fax:** (708) 891-0904
- **Mailing address:** 1700 E WEST RD, CALUMET CITY, IL 60409-5415
- **Mailing address phone:** (708) 891-3330
- **Mailing address fax:** (708) 891-0904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 02/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 141037 | MEDICARE FACILITY | IL |
| 05 | — | 7001399 | — | IL |
| 01 | — | CN5008 | RAILROAD MEDICARE | IL |