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General NPI Number Information
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NPI Number | 1649610593
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Entity Type | Organization
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Legal Business Name | ZB OPTICAL INC.
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 7847 S MARYLAND AVE SUITE 100B
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City | CHICAGO
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State | IL
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Zip | 60619
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Country | US
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Telephone | 773-602-9402
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Fax | 866-713-4743
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Provider Business Mailing Address
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Address Line | 7847 S MARYLAND AVE SUITE 100B
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City | CHICAGO
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State | IL
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Zip | 60619-3109
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Country | US
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Telephone | 773-602-9402
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Fax | 866-713-4743
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Authorized Official
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Title or Position | PRINCIPAL / MANAGING DIRECTOR
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Name | GREGORY HOLSTON
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Credential |
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Telephone | 773-602-9402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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