Organization
MIDWEST EYE CLINIC, INC
Active
Other names
Midwest Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO CARRASCO (PRESIDENT)
(773) 581-1515
Entity
Organization
Contact information
Practice address
6254 S PULASKI RD, CHICAGO, IL 60629-4610
(773) 581-1515
(773) 581-9663
Mailing address
6254 S PULASKI RD, CHICAGO, IL 60629-4610
(773) 581-1515
(773) 581-9663
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
346002682
IL
Other
Enumeration date
07/12/2008
Last updated
07/12/2008
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