Healthcare Provider Details

I. General information

NPI: 1568461853
Provider Name (Legal Business Name): FRANCIS XAVIER COTTONE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6322 S ARCHER AVE
CHICAGO IL
60638-2521
US

IV. Provider business mailing address

6322 S ARCHER AVE
CHICAGO IL
60638-2521
US

V. Phone/Fax

Practice location:
  • Phone: 773-585-2022
  • Fax: 773-585-2027
Mailing address:
  • Phone: 773-585-2022
  • Fax: 773-585-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046007321
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: