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NPI Code Detail

MEDICARE: OPTICA 2000

MEDICARE: OPTICA 2000
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
1332H00000XEyewear Supplier2152593IL

General Provider Information

NPI Number : 1518345263
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTICA 2000
Provider Business Mailing Address
First Line : 2706 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1308
Country : US
Telephone Number : 773-862-5000
Fax Number : 773-862-5059
Provider Business Practice Location Address
First Line : 2706 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1308
Country : US
Telephone Number : 773-862-5000
Fax Number : 773-862-5059
Authorized Official
Title or Position : MANAGER
Name : MR. DANIEL PRIETO
Credential :
Telephone Number : 773-862-5000
Provider Enumeration Date : 05/14/2015
Last Update Date : 05/14/2015

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Directions to “OPTICA 2000 ” Practice Location

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