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Organization
ADVANCE VISION EYE CARE, S.C.
Active
Organization
ADVANCE VISION EYE CARE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUNG MAUNG TIN MD (MEDICAL DOCTOR/ OPHTHALMOLOGIST)
(217) 233-1405
Entity
Organization
Contact information
Practice address
1770 E LAKE SHORE DR, SUITE 101, DECATUR, IL 62521-3886
(217) 233-1405
(217) 233-1407
Mailing address
1770 E LAKE SHORE DRIVE, SUITE 101, DECATUR, IL 62521-3886
(217) 233-1405
(217) 233-1407
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036101730
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101730
—
IL
01
—
042618472
CORPORATION LICENSE
—
Enumeration date
08/25/2006
Last updated
01/06/2009
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