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Organization

SENIOR EYE ASSOCIATES SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN CHRISTOPHER BARNES O.D. (PRESIDENT)
(773) 792-1011
Entity
Organization

Contact information

Practice address
6601 N AVONDALE AVE STE 102, CHICAGO, IL 60631-1567
(773) 792-1011
(773) 889-0224
Mailing address
PO BOX 2354, NORTHBROOK, IL 60065-2354
(773) 792-1011
(773) 889-0224

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1622243
BCBS IL GROUP NUMBER
IL
Enumeration date
02/10/2007
Last updated
02/21/2023
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