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NPI Code Detail

MEDICARE: DR. RAID JOSEPH ALBATCHE O.D.

MEDICARE: DR. RAID JOSEPH ALBATCHE 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
1152W00000XOptometrist046.010850IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01423830OTHERILRAILROAD MEDICARE

General Provider Information

NPI Number : 1528462660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAID JOSEPH ALBATCHE O.D.
Provider Business Mailing Address
First Line : 3500 W PETERSON AVE STE 401
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3307
Country : US
Telephone Number : 773-588-3090
Fax Number : 773-588-3210
Provider Business Practice Location Address
First Line : 3500 W PETERSON AVE STE 401
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3307
Country : US
Telephone Number : 773-588-3090
Fax Number : 773-588-3210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 04/13/2015

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