Provider Demographics
NPI:1447462288
Name:NEW LENOX FAMILY EYECARE LTD
Entity type:Organization
Organization Name:NEW LENOX FAMILY EYECARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUBANKO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-485-6533
Mailing Address - Street 1:1230 N CEDAR RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1272
Mailing Address - Country:US
Mailing Address - Phone:815-485-6533
Mailing Address - Fax:
Practice Address - Street 1:1230 N CEDAR RD UNIT A
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1272
Practice Address - Country:US
Practice Address - Phone:815-485-6533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9000022896OtherVISION SERVICE PLAN INS
212305OtherMEDICARE PTAN
IL09932408OtherBLUE CROSS BLUE SHIELD
212305OtherMEDICARE PTAN
IL9000022896OtherVISION SERVICE PLAN INS
ILU84492Medicare UPIN