MEDICARE: SCHWARTZ EYE CARE, 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	046006707	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932186657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHWARTZ EYE CARE, INC.

Provider Business Mailing 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

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	:	OWNER
Name	:	GAIL SCHWARTZ
Credential	:
Telephone Number	:	312-421-5870

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	08/07/2008

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