Healthcare Provider Details

I. General information

NPI: 1023243433
Provider Name (Legal Business Name): ROSIN OPTICAL CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548 E 55TH ST
CHICAGO IL
60615-5550
US

IV. Provider business mailing address

6233 CERMAK RD
BERWYN IL
60402-2317
US

V. Phone/Fax

Practice location:
  • Phone: 773-667-0024
  • Fax: 773-667-0218
Mailing address:
  • Phone: 708-749-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS A. CHIARAMONTI JR.
Title or Position: DIRECTOR OF PROFESSIONAL SERVICES
Credential: O.D.
Phone: 630-546-8319