=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770268583
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHARLES HAUFF OD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2023
-----------------------------------------------------
Last Update Date | 08/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HIGHLAND AVE
-----------------------------------------------------
City | MALDEN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02148-6603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-321-9039
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1243 SANDPIPER CT
-----------------------------------------------------
City | GRAYSLAKE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60030-3209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-545-7208
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | ODTG00775
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPT8317
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------