Provider Demographics
NPI:1528255627
Name:NORTHWEST EYE PHYSICIANS, LTD
Entity type:Organization
Organization Name:NORTHWEST EYE PHYSICIANS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-392-9220
Mailing Address - Street 1:1588 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3906
Mailing Address - Country:US
Mailing Address - Phone:847-392-9220
Mailing Address - Fax:847-392-9252
Practice Address - Street 1:1588 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3906
Practice Address - Country:US
Practice Address - Phone:847-392-9220
Practice Address - Fax:847-392-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622540OtherBCBS
IL01633328OtherIL BCBS
IL036048813 1Medicaid
IL036102073 2Medicaid
IL21624009OtherBCBS
ILCC2168OtherRETIRED RAILROAD MEDICARE
IL036037301 1Medicaid
IL036098011 1Medicaid
IL21600924OtherBCBS
IL01633328OtherIL BCBS
ILCC2168OtherRETIRED RAILROAD MEDICARE
ILG79163Medicare UPIN
ILC41829Medicare UPIN
IL0442800001Medicare NSC
IL036098011 1Medicaid