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NPI Code Detail

MEDICARE: WINITZ OPTICAL INC.

MEDICARE: WINITZ OPTICAL 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
1152W00000XOptometrist046009919IL

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 : 1952839599
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINITZ OPTICAL INC.
Provider Business Mailing Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4151 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST/PARTNER
Name : ALEXIS SCATCHELL
Credential : OD
Telephone Number : 773-458-3230
Provider Enumeration Date : 05/26/2017
Last Update Date : 08/07/2017

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