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Contact Information

SUBURBAN EYE SPECIALISTS
10436 SOUTHWEST HWY STE 101
CHICAGO RIDGE, IL60415-2282
 Phone: 708-586-4922
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Optometric Technician

156FX1202X
Indicates primary specialty

NPI Profile & details for SUBURBAN EYE SPECIALISTS

NPI # 1043794506
LBN Legal business name SUBURBAN EYE SPECIALISTS
Authorized official BENJAMIN TICHO - (AUTHORIZED OFFICIAL/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2018
Last updated 10/07/2024 - More than a year ago
Identifiers
IL Medicaid 300622839
IN Medicaid 300016721
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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