MEDICARE: WEAR EYEWEAR, 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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1932322831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEAR EYEWEAR, INC.

Provider Business Mailing Address
First Line	:	750 N FRANKLIN ST
Second Line	:	SUITE 106
City	:	CHICAGO
State	:	IL
Zip	:	60654-6263
Country	:	US
Telephone Number	:	312-255-1212
Fax Number	:	312-255-1367

Provider Business Practice Location Address
First Line	:	750 N FRANKLIN ST
Second Line	:	SUITE 106
City	:	CHICAGO
State	:	IL
Zip	:	60654-6263
Country	:	US
Telephone Number	:	312-255-1212
Fax Number	:	312-255-1367

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH WINJUM
Credential	:
Telephone Number	:	312-255-1212

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	01/04/2017

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