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NPI Code Detail

MEDICARE: ANITA HAN OPTOMETRY, LLC

MEDICARE: ANITA HAN OPTOMETRY, LLC
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
1152W00000XOptometrist046010088IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11780846147OTHERILDEPARTMENT OF HEALTH AND HUMAN SERVICES

General Provider Information

NPI Number : 1285873711
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANITA HAN OPTOMETRY, LLC
Provider Business Mailing Address
First Line : 1101 S STATE ST
Second Line : UNIT 1402
City : CHICAGO
State : IL
Zip : 60605-3175
Country : US
Telephone Number : 847-452-9188
Fax Number : 847-537-4855
Provider Business Practice Location Address
First Line : 2013 MILWAUKEE AVE
Second Line :
City : RIVERWOODS
State : IL
Zip : 60015-3581
Country : US
Telephone Number : 224-676-1022
Fax Number : 224-676-2050
Authorized Official
Title or Position : PRESIDENT
Name : DR. ANITA MI-YOUNG HAN
Credential : O.D.
Telephone Number : 224-676-1022
Provider Enumeration Date : 02/06/2009
Last Update Date : 01/25/2018

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Directions to “ANITA HAN OPTOMETRY, LLC ” Practice Location

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