MEDICARE: WILLIAM A ERNSTEIN O.D.

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
1	152W00000X	Optometrist		IL

General Provider Information

NPI Number	:	1427133420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM A ERNSTEIN O.D.

Provider Business Mailing Address
First Line	:	251 E NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8114
Country	:	US
Telephone Number	:	847-358-4950
Fax Number	:	847-358-4990

Provider Business Practice Location Address
First Line	:	251 E NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8114
Country	:	US
Telephone Number	:	847-358-4950
Fax Number	:	847-358-4990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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