Provider Demographics
NPI:1093898967
Name:NORTHWEST EYE CENTER
Entity type:Organization
Organization Name:NORTHWEST EYE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-382-3640
Mailing Address - Street 1:720 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1852
Mailing Address - Country:US
Mailing Address - Phone:847-382-3640
Mailing Address - Fax:847-382-3692
Practice Address - Street 1:720 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1852
Practice Address - Country:US
Practice Address - Phone:847-382-3640
Practice Address - Fax:847-382-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL640250Medicare PIN
ILD12053Medicare UPIN
IL0363900001Medicare NSC