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Contact Information

GUSTAFSON EYE CARE CLINICS, LTD.
96 W NORTHWEST HWY
PALATINE, IL60067-3571
 Phone: 847-358-7722
 Fax: 847-520-3280
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for GUSTAFSON EYE CARE CLINICS, LTD.

NPI Number 1215138771
LBN Legal business name GUSTAFSON EYE CARE CLINICS, LTD.
Authorized official THOMAS GUSTAFSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/30/2007
Last updated 03/13/2020 - About 6 years ago
Identifiers
IL License # 046008241
IL Medicaid 8241
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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