Black Eye Group, L.l.c.

NPI 1063776292 - Optometrist - 152W00000X

NPI Details
NPI 1063776292
Enumeration Date 07/03/2012
Last Updated 07/03/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name ADAM ADAM
Position OWNER
Phone (510) 847-6959
Fax
Practice Location
16660 S WINDSOR LN
LOCKPORT IL, 60441-6286, US
Phone (510) 847-6959
Fax
Business Location
16660 S WINDSOR LN
LOCKPORT IL, 60441-6286, US
Phone (510) 847-6959
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Illinois
License Number 046.010312
Remove 1063776292 NPI Number
 

According to our database, Black Eye Group, L.l.c. NPI is 1063776292, taxonomy code is 152W00000X and license number is 046.010312, license state is located at Illinois. Black Eye Group, L.l.c. physically located at 16660 S Windsor Ln, Lockport IL, 60441-6286. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1063776292 NPI number is provided on an as is basis without warranty of any kind. 1063776292 is maintained by the National Plan & Provider Enumeration System. The contents of Black Eye Group, L.l.c. are for informational purposes only.