Eye See Ravenswood, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009834 Issued in IL

Legal business name

EYE SEE RAVENSWOOD, PC

Practice address

4735 North Damen Ave
Eye See Ravenswood, PC
Chicago, IL 60640

Phone

(773) 961-8700

Fax

(773) 961-8703

NPI assigned

Mar 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrea J Stein, O.D.

Title

Owner

Phone

(773) 961-8700

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1285875823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 NORTH DAMEN AVE",
            "address_2": "EYE SEE RAVENSWOOD, PC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-961-8700",
            "fax_number": "773-961-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 NORTH DAMEN AVE",
            "address_2": "EYE SEE RAVENSWOOD, PC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-961-8700",
            "fax_number": "773-961-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SEE RAVENSWOOD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-961-8700",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205388193",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.