MEDICARE: ROSIN OPTICAL CO., INC.

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
2	332B00000X	Durable Medical Equipment & Medical Supplies

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA2163	OTHER		MEDICARE RR

General Provider Information

NPI Number	:	1881808897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSIN OPTICAL CO., INC.

Provider Business Mailing Address
First Line	:	1346 PATRIOT BLVD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-7777
Country	:	US
Telephone Number	:	847-729-5050
Fax Number	:	224-521-2995

Provider Business Practice Location Address
First Line	:	1346 PATRIOT BLVD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-7777
Country	:	US
Telephone Number	:	847-729-5050
Fax Number	:	224-521-2995

Authorized Official
Title or Position	:	DIRECTOR OF PROFESSIONAL SERVICES
Name	:	DR. NICHOLAS A. CHIARAMONTI JR.
Credential	:	O.D.
Telephone Number	:	630-546-8319

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	05/18/2010

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Directions to “ROSIN OPTICAL CO., INC. ” Practice Location

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