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NPI Code Detail

MEDICARE: LAWRENCE GREENSPAN PROFESSIONAL CORPORATION

MEDICARE: LAWRENCE GREENSPAN PROFESSIONAL CORPORATION
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
1152W00000XOptometrist046006461IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619157872
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWRENCE GREENSPAN PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 366 DIXIE HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-1758
Country : US
Telephone Number : 708-754-0080
Fax Number : 708-754-0089
Provider Business Practice Location Address
First Line : 366 DIXIE HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-1758
Country : US
Telephone Number : 708-754-0080
Fax Number : 708-754-0089
Authorized Official
Title or Position : PRESIDENT
Name : DR. RONALD E. GREENSPAN
Credential : O.D.
Telephone Number : 708-754-0080
Provider Enumeration Date : 11/05/2007
Last Update Date : 11/11/2008

Similar Medicare Providers

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Practice Location Address:
366 DIXIE HWY
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Practice Phone: 708-754-0080
Practice Fax: 708-754-0089
1295817930 — DR. EDWARD H SHPRITZ O.D.
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1992936454 — DR. GARY KEVIN YONG O.D.
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366 DIXIE HWY
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Practice Fax:
1427427418 — KATHRINE HOLMBERG O.D
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CHICAGO HEIGHTS, IL
60411-1758
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Practice Fax:
1902335391 — DR. TIFFANY HN TANG OD
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1073027348 — HOLMBERG OPTOMETRIC LTD
Practice Location Address:
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Practice Fax: 708-754-0089

Directions to “LAWRENCE GREENSPAN PROFESSIONAL CORPORATION ” Practice Location

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