Organization
PROFESSIONAL EYE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANIE C. WASHINGTON O.D., M.P.H. (PRESIDENT/ OPTOMETRIST)
(773) 363-9447
Entity
Organization
Contact information
Practice address
1517 E 53RD ST, CHICAGO, IL 60615-4509
(773) 363-9447
(773) 363-9675
Mailing address
1517 E 53RD ST, CHICAGO, IL 60615-4509
(773) 363-9447
(773) 363-9675
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008653
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008653
—
IL
Enumeration date
05/05/2008
Last updated
06/24/2009
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