| Organization Name: | CLC VISION LLC |
| NPI Number: | 1235288564 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLBY LEE CARTER (OWNER) |
| Mailing Address: | 7317 W 25th Street North Riverside |
| State: | IL US |
| Postal Code: | 60546 |
| Phone Number: | 7084428899 |
| Fax Number: | 7084429466 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |