Provider Demographics
NPI:1992098263
Name:DARWIN EYE CARE LLC
Entity type:Organization
Organization Name:DARWIN EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARWIN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:CHENTNIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:414-384-2020
Mailing Address - Street 1:3800 S. 27TH ST.
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221
Mailing Address - Country:US
Mailing Address - Phone:414-384-2020
Mailing Address - Fax:414-383-5099
Practice Address - Street 1:3800 S. 27TH ST.
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221
Practice Address - Country:US
Practice Address - Phone:414-384-2020
Practice Address - Fax:414-383-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI2896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty