MEDICARE: ROSIN EYECARE P.C.

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

General Provider Information

NPI Number	:	1740847086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSIN EYECARE P.C.

Provider Business Mailing Address
First Line	:	6233 CERMAK RD
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402-2317
Country	:	US
Telephone Number	:	708-749-2020
Fax Number	:	708-749-2069

Provider Business Practice Location Address
First Line	:	412 ELYSIAN FIELDS RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-4211
Country	:	US
Telephone Number	:	615-834-8495
Fax Number	:	615-833-1143

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY COLEY
Credential	:	OD
Telephone Number	:	615-491-3847

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	09/12/2023

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