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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

NPI Number 1619092863
LBN Legal business name PREMIER EYECARE CENTER PC
Authorized official ROBERT TOAL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/20/2007
Last updated 06/11/2018 - About 8 years ago
Identifiers
IL License # 046008356
IL Other 06732021 BLUE CROSS BLUE SHIELD
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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