MEDICARE: DR NEIL W MARGOLIS OD PC

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	152WV0400X	Vision Therapy Optometrist	152W00000X	IL
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1881812162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR NEIL W MARGOLIS OD PC

Provider Business Mailing Address
First Line	:	3250 N. ARLINGTON HEIGHTS RD.
Second Line	:	SUITE 109
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4767
Country	:	US
Telephone Number	:	847-255-1040
Fax Number	:	847-506-0843

Provider Business Practice Location Address
First Line	:	3250 N. ARLINGTON HEIGHTS RD
Second Line	:	SUITE 109
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1534
Country	:	US
Telephone Number	:	847-255-1040
Fax Number	:	847-506-0843

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. NEIL W MARGOLIS
Credential	:	OD
Telephone Number	:	847-255-1040

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	05/14/2020

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