Crystal Lake Ophthalmology Associates Pc

LBN: Crystal Lake Ophthalmology Associates Pc
Crystal Lake Ophthalmology Associates Pc is an health care organization with primary practice located at 280A Memorial Ct 280A Memorial Ct, Crystal Lake IL 60014-6233. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Crystal Lake Ophthalmology Associates Pc can be contacted via phone (815) 455-4222, or through Dolezal, Edward Geo via phone (815) 455-4222.

Contact Information

Primary practice address
280A Memorial Ct 280A Memorial Ct Crystal Lake IL 60014-6233
Fax: (815) 455-5093
Website:
Authorized official contact:
Name: Dolezal, Edward Geo Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036070162 Illinois

Profile Details

NPI number 1669530838
LBN Legal business name Crystal Lake Ophthalmology Associates Pc
DBA Doing business as
Authorized official Dolezal, Edward Geo Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2006
Last updated Feb 28th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669530838 NPPES
Illinois MEDICAID 036070162
Illinois Other 180038854

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