Organization
ADVANCED EYECARE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROCKS OD (PRESIDENT)
(847) 854-0202
Entity
Organization
Contact information
Practice address
45 W ACORN LN, LAKE IN THE HILLS, IL 60156-4804
(847) 854-0202
Mailing address
45 W ACORN LN, LAKE IN THE HILLS, IL 60156-4804
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
046009272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG7196
MEDICARE RAILROAD PTAN
—
Enumeration date
09/18/2007
Last updated
06/23/2008
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