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NPI Code Detail

MEDICARE: NEW VISION OPTICAL

MEDICARE: NEW VISION OPTICAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)1935IL

General Provider Information

NPI Number : 1194719112
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW VISION OPTICAL
Provider Business Mailing Address
First Line : 24081 FLINT CREEK DR
Second Line :
City : LAKE BARRINGTON
State : IL
Zip : 60010-1581
Country : US
Telephone Number : 847-251-3330
Fax Number : 847-251-9580
Provider Business Practice Location Address
First Line : 120 SKOKIE BLVD
Second Line :
City : WILMETTE
State : IL
Zip : 60091-3050
Country : US
Telephone Number : 847-251-3330
Fax Number : 847-251-9580
Authorized Official
Title or Position : PRESIDENT
Name : MR. ALBERTO ANTMAN
Credential :
Telephone Number : 847-251-3330
Provider Enumeration Date : 09/06/2005
Last Update Date : 09/27/2007

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Directions to “NEW VISION OPTICAL ” Practice Location

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