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General NPI Number Information
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NPI Number | 1578694386
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Entity Type | Organization
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Legal Business Name | ZIVA OPTICAL, LTD.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 1243 W BOUGHTON RD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1509
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Country | US
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Telephone | 630-679-0900
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Fax | 630-679-0213
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Provider Business Mailing Address
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Address Line | 1243 W BOUGHTON RD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1509
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Country | US
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Telephone | 630-679-0900
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Fax | 630-679-0213
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RORY K. ZIMNY
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Credential |
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Telephone | 630-921-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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