Healthcare Provider Details

I. General information

NPI: 1114172012
Provider Name (Legal Business Name): DRS. AIDE AND ASSELL OPTOMETRISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 N ROSELLE RD
HOFFMAN ESTATES IL
60169-4930
US

IV. Provider business mailing address

1115 N ROSELLE RD
HOFFMAN ESTATES IL
60169-4930
US

V. Phone/Fax

Practice location:
  • Phone: 847-885-2030
  • Fax: 847-885-2817
Mailing address:
  • Phone: 847-885-2030
  • Fax: 847-885-2817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046006098
License Number StateIL

VIII. Authorized Official

Name: JANICE SIMKUS
Title or Position: INSURANCE BILLER
Credential:
Phone: 847-301-2727