Organization
ILLINOIS EYE ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY M PIETRZYK O.D. (PRESIDENT)
(815) 478-0100
Entity
Organization
Contact information
Practice address
540 W NORTH ST, SUITE 209, MANHATTAN, IL 60442-8201
(815) 478-0100
(815) 478-9100
Mailing address
540 W NORTH ST, SUITE 209, MANHATTAN, IL 60442-8201
(815) 478-0100
(815) 478-9100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009714
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7499
RAILROAD MEDICARE
—
Enumeration date
11/01/2006
Last updated
09/17/2012
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