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General NPI Number Information
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NPI Number | 1588973556
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Entity Type | Organization
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Legal Business Name | CENTRAL OPTICAL CENTER, INC.
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 5526 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4129
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Country | US
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Telephone | 773-282-1718
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Fax |
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Provider Business Mailing Address
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Address Line | 5526 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4129
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ALICJA ALVAREZ
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Credential |
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Telephone | 773-282-1718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1101X
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Taxonomy Name | Ophthalmic Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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