MEDICARE: DARRIN VITS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046008815	IL

General Provider Information

NPI Number	:	1164502001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRIN VITS OD

Provider Business Mailing Address
First Line	:	723 W ROUTE 30
Second Line	:
City	:	ROCK FALLS
State	:	IL
Zip	:	61071-2828
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 W ROUTE 30
Second Line	:
City	:	ROCK FALLS
State	:	IL
Zip	:	61071-2828
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	08/08/2018

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