Organization
ADVANCED EYECARE GROUP PC
Active
Other names
Drs Jessen Wesley And Assoc
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA E O'HAGAN (OFFICE MANAGER)
(708) 848-3900
Entity
Organization
Contact information
Practice address
7011 NORTH AVE, OAK PARK, IL 60302-1001
(708) 848-3900
(708) 848-3997
Mailing address
7011 NORTH AVE, OAK PARK, IL 60302-1001
(708) 848-3900
(708) 848-3997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001616047
BLUE CROSS BLUE SHIELD
IL
01
—
P00173468
RAILROAD MEDICARE
IL
Enumeration date
06/11/2006
Last updated
11/06/2007
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