Healthcare Provider Details

I. General information

NPI: 1881808897
Provider Name (Legal Business Name): ROSIN OPTICAL CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 PATRIOT BLVD
GLENVIEW IL
60026-7777
US

IV. Provider business mailing address

1346 PATRIOT BLVD
GLENVIEW IL
60026-7777
US

V. Phone/Fax

Practice location:
  • Phone: 847-729-5050
  • Fax: 224-521-2995
Mailing address:
  • Phone: 847-729-5050
  • Fax: 224-521-2995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
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