MEDICARE: DR. MICHAEL BINDER O.D.

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		IL

General Provider Information

NPI Number	:	1598738353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BINDER O.D.

Provider Business Mailing Address
First Line	:	2658 WEST ST
Second Line	:
City	:	RIVER GROVE
State	:	IL
Zip	:	60171-1628
Country	:	US
Telephone Number	:	708-456-8343
Fax Number	:	312-421-5870

Provider Business Practice Location Address
First Line	:	749 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-5655
Country	:	US
Telephone Number	:	312-421-5870
Fax Number	:	312-421-5910

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	07/08/2007

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