National Provider Identifier Database

CRYSTAL LAKE OPHTHALMOLOGY ASSOCIATES PC
Ophthalmology

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.


Contact Information

CRYSTAL LAKE OPHTHALMOLOGY ASSOCIATES PC
280A MEMORIAL CT
280A MEMORIAL CT
CRYSTAL LAKE, IL60014-6233
Phone: 815-455-4222
Fax: 815-455-5093
Website:
Specialty Taxonomy Code
* Ophthalmology 207W00000X

* Indicates primary specialty

NPI Profile & details for CRYSTAL LAKE OPHTHALMOLOGY ASSOCIATES PC

NPI Number 1669530838
Legal business name
LBN
CRYSTAL LAKE OPHTHALMOLOGY ASSOCIATES PC
Authorized official EDWARD DOLEZAL - (PHYSICIAN OWNER)
Entity Organization
Organization subpart No
Enumeration date 12/04/2006
Last updated 02/28/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036070162
  • IL Medicaid: 036070162
  • Other: 180038854 RAILROAD MEDICARE

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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