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NPI Code Detail

MEDICARE: HYDE PARK VISION CENTER LTD.

MEDICARE: HYDE PARK VISION CENTER LTD.
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
1152W00000XOptometristIL

General Provider Information

NPI Number : 1952599987
Entity Type Code : Organization
Provider Name (Legal Business Name) : HYDE PARK VISION CENTER LTD.
Provider Business Mailing Address
First Line : 1200 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4008
Country : US
Telephone Number : 773-493-8372
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4008
Country : US
Telephone Number : 773-493-8372
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. DREW F KLEIN
Credential : O.D.
Telephone Number : 773-493-8372
Provider Enumeration Date : 10/03/2007
Last Update Date : 10/03/2007

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Directions to “HYDE PARK VISION CENTER LTD. ” Practice Location

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