Organization
NEW LENOX FAMILY EYECARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE BUBANKO O.D. (SECRETARY TREASURER)
(815) 485-6533
Entity
Organization
Contact information
Practice address
1230 N CEDAR RD UNIT A, NEW LENOX, IL 60451-1272
(815) 485-6533
Mailing address
1230 N CEDAR RD UNIT A, NEW LENOX, IL 60451-1272
(815) 485-6533
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932408
BLUE CROSS BLUE SHIELD
IL
01
—
212305
MEDICARE PTAN
—
01
—
9000022896
VISION SERVICE PLAN INS
IL
Enumeration date
05/04/2007
Last updated
04/04/2025
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