MEDICARE: I.F.OPTICAL CO., INC.

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	156FX1800X	Optician

General Provider Information

NPI Number	:	1518949692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I.F.OPTICAL CO., INC.

Provider Business Mailing Address
First Line	:	2812 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2902
Country	:	US
Telephone Number	:	773-761-8969
Fax Number	:	773-761-3601

Provider Business Practice Location Address
First Line	:	2812 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2902
Country	:	US
Telephone Number	:	773-761-8969
Fax Number	:	773-761-3601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ISRAEL FREUND
Credential	:	OPTICIAN
Telephone Number	:	773-761-8969

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	12/08/2008

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