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General NPI Number Information
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NPI Number | 1376673863
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Entity Type | Organization
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Legal Business Name | EYE SPECIALISTS OF CHICAGO AND HIGHLAND PARK
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5600 W ADDISON ST SUITE 102
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City | CHICAGO
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State | IL
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Zip | 60634-4401
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Country | US
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Telephone | 773-736-1717
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Fax | 773-736-7538
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Provider Business Mailing Address
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Address Line | 5600 W ADDISON ST SUITE 102
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City | CHICAGO
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State | IL
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Zip | 60634-4401
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Country | US
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Telephone | 773-736-1717
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Fax | 773-736-7538
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | MRS. VALENTINA RUEHL
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Credential |
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Telephone | 773-736-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IL
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