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General NPI Number Information
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NPI Number | 1952770604
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Entity Type | Organization
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Legal Business Name | INDUSTRIAL OPTICAL SERVICE, INC
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 2843 PFINGSTEN RD
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City | GLENVIEW
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State | IL
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Zip | 60026-1153
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Country | US
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Telephone | 847-205-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 444 N WABASH AVE STE 320
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City | CHICAGO
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State | IL
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Zip | 60611-3539
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Country | US
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Telephone | 312-945-7192
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Fax |
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Authorized Official
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Title or Position | MANAGING DOCTOR
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Name | CARRIE ROITSTEIN
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Credential | OD
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Telephone | 312-945-7192
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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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