Healthcare Provider Details

I. General information

NPI: 1679730410
Provider Name (Legal Business Name): DOYLE OPTICIANS LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 CHESTNUT ST
WINNETKA IL
60093-2201
US

IV. Provider business mailing address

565 CHESTNUT ST
WINNETKA IL
60093-2201
US

V. Phone/Fax

Practice location:
  • Phone: 847-446-6264
  • Fax:
Mailing address:
  • Phone: 847-446-6264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1119-6300
License Number StateIL

VIII. Authorized Official

Name: MR. SHAWN M SCOTT
Title or Position: MGR
Credential: ABOC
Phone: 847-446-6264