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Contact Information

BUENA VISTA OPTICAL, P.C.
6455 S KEDZIE AVE
CHICAGO, IL60629-2829
 Phone: 773-863-9234
 Fax: 773-863-9274
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic/Center

261Q00000X
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for BUENA VISTA OPTICAL, P.C.

NPI # 1740464296
LBN Legal business name BUENA VISTA OPTICAL, P.C.
Authorized official TODD SIMS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2007
Last updated 09/11/2013 - About 13 years ago
Identifiers
IL License # 046-009243
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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