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Organization

FAMILY EYE PHYSICIANS, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMAD AL-KHUDARI MD (PRESIDENT)
(708) 636-9393
Entity
Organization

Contact information

Practice address
6201 W 95TH ST, OAK LAWN, IL 60453-2701
(708) 636-9393
(708) 636-2022
Mailing address
6201 W 95TH ST, OAK LAWN, IL 60453-2701
(708) 636-9393
(708) 636-2022

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046009744
IL
207W00000X
Ophthalmology Physician
Primary
036103747
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001633597
BCBS PROVIDER ID
IL
01
120602
ADVOCATE HLTH PARTNERS ID
IL
01
125181500
US DEPT OF LABOR
IL
01
B0830165
EYEFINITY CLEARING HOUSE
IL
Enumeration date
11/15/2006
Last updated
02/16/2023
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