Provider Demographics
NPI:1992714463
Name:ADAMS EYECARE, PC
Entity type:Organization
Organization Name:ADAMS EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-377-7722
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-0010
Mailing Address - Country:US
Mailing Address - Phone:630-377-7722
Mailing Address - Fax:
Practice Address - Street 1:3310 W MAIN ST
Practice Address - Street 2:SUITE 180
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1000
Practice Address - Country:US
Practice Address - Phone:630-377-7722
Practice Address - Fax:630-377-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008731152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU54453Medicare PIN
ILIL2404Medicare Oscar/Certification