Provider Demographics
NPI:1043330418
Name:ATKINSON EYE CARE, P.C.
Entity type:Organization
Organization Name:ATKINSON EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-854-5700
Mailing Address - Street 1:2100 N. HUNTINGTON DRIVE, UNIT A
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5940
Mailing Address - Country:US
Mailing Address - Phone:847-854-5700
Mailing Address - Fax:847-854-5762
Practice Address - Street 1:2100 N. HUNTINGTON DRIVE, UNIT A
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5940
Practice Address - Country:US
Practice Address - Phone:847-854-5700
Practice Address - Fax:847-854-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU36830Medicare UPIN
375830Medicare PIN
IL375830Medicare PIN
IL0978330001Medicare NSC