Provider Demographics
NPI:1316083561
Name:CHIZEK FAMILY EYECARE INC
Entity type:Organization
Organization Name:CHIZEK FAMILY EYECARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CHIZEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:563-359-4446
Mailing Address - Street 1:1875 MIDDLE ROAD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722
Mailing Address - Country:US
Mailing Address - Phone:563-359-4446
Mailing Address - Fax:563-359-0381
Practice Address - Street 1:1875 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3203
Practice Address - Country:US
Practice Address - Phone:563-359-4446
Practice Address - Fax:563-359-0381
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIZEK FAMILY EYECARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IABC36386OtherBLUE CROSS
IAI16942Medicare ID - Type Unspecified
IABC36386OtherBLUE CROSS