GRAYSLAKE EYECARE ASSOC LTD NPI 1003031030

Optometrist in Grayslake, IL

NPI 1003031030 Organization Optometrist

About GRAYSLAKE EYECARE ASSOC LTD

Grayslake Eyecare Assoc Ltd is a provider established in Grayslake, Illinois specializing in optometrist. The NPI number of Grayslake Eyecare Assoc Ltd is 1003031030 and was assigned on April 2007. The practitioner's primary taxonomy code is 152W00000X with license number 046009065 (IL). The provider is registered as an organization and their NPI record was last updated 4 years ago. Grayslake Eyecare Assoc Ltd operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Scott Pouyat Od (Optometrist)

NPI

1003031030

Provider NameGRAYSLAKE EYECARE ASSOC LTD
Provider Location Address661 N LAKE ST GRAYSLAKE, IL 60030
Provider Mailing Address661 N LAKE ST GRAYSLAKE, IL 60030
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-16-2007
Last Update Date07-21-2017


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.046009065
License StateIL
Taxonomy DescriptionDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

GRAYSLAKE EYECARE ASSOC LTD
661 N LAKE ST
GRAYSLAKE, IL
ZIP 60030
Phone: (847) 223-7600
Fax: (847) 548-7653

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Mailing Address

GRAYSLAKE EYECARE ASSOC LTD
661 N LAKE ST
GRAYSLAKE, IL
ZIP 60030
Phone: (847) 223-7600
Fax: (847) 548-7653



Authorized Official

Authorized Official NameDR. SCOTT POUYAT OD
Authorized Official TitleOPTOMETRIST
Authorized Official Phone(847) 223-7600

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.