Organization
EYE CARE CENTER OF LAKE COUNTY REFRACTIVE SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE MERKT (ADMINISTRATOR)
(847) 244-1657
Entity
Organization
Contact information
Practice address
6 E PHILLIP RD, SUITE 1110, VERNON HILLS, IL 60061-1700
(847) 244-1657
Mailing address
2424 WASHINGTON ST, WAUKEGAN, IL 60085-5074
(847) 244-1657
(847) 244-5122
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04915265
BLUE CROSS - BLUE SHIELD
IL
Enumeration date
04/12/2007
Last updated
08/22/2020
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