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Contact Information

PREMIER EYECARE CENTER PC
742 N MARKET ST
SUITE A
WATERLOO, IL62298
 Phone: 618-939-4040
 Fax: 618-939-3903
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for PREMIER EYECARE CENTER PC · (Female)

NPI Number 1619092863
Status Active
Credentials
Entity Individual
Enumeration date 03/20/2007
Last updated 06/11/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 046008356
  • IL Other 06732021 BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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