Basic Information
| Provider Information | |||||||||
| NPI: | 1609878040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEINER | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | GENEVA EYE CLINIC LTD | ||||||||
| Address2: | 302 RANDALL RD STE 10 | ||||||||
| City: | GENEVA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302327011 | ||||||||
| FaxNumber: | 6302327011 | ||||||||
| Practice Location | |||||||||
| Address1: | GENEVA EYE CLINIC LTD | ||||||||
| Address2: | 302 RANDALL RD STE 10 | ||||||||
| City: | GENEVA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302321282 | ||||||||
| FaxNumber: | 6302327011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 03/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046-008186 | IL | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 046008186 | 05 | IL | MEDICAID |