Healthcare Provider Details

I. General information

NPI: 1881812162
Provider Name (Legal Business Name): DR NEIL W MARGOLIS OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 N. ARLINGTON HEIGHTS RD SUITE 109
ARLINGTON HEIGHTS IL
60004-1534
US

IV. Provider business mailing address

3250 N. ARLINGTON HEIGHTS RD. SUITE 109
ARLINGTON HEIGHTS IL
60004-4767
US

V. Phone/Fax

Practice location:
  • Phone: 847-255-1040
  • Fax: 847-506-0843
Mailing address:
  • Phone: 847-255-1040
  • Fax: 847-506-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number152W00000X
License Number StateIL

VIII. Authorized Official

Name: DR. NEIL W MARGOLIS
Title or Position: OPTOMETRIST
Credential: OD
Phone: 847-255-1040