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Organization

PROGRESSIVE EYE CARE SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PATRICIA LOUISE DAVIS M.D. (PHYSICIAN OWNER)
(630) 527-1920
Entity
Organization

Contact information

Practice address
3100 OGDEN AVE, LISLE, IL 60532-1603
(630) 527-1920
(630) 527-0125
Mailing address
3100 OGDEN AVE, LISLE, IL 60532-1603
(630) 527-1920

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02222972
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/22/2006
Last updated
10/15/2007
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