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MODERN OPTICAL EYEWEAR INC. NPI 1346384450


NPI Information

NPI: 1346384450
Provider Name: MODERN OPTICAL EYEWEAR, INC.
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
2812 W FOSTER AVE
CHICAGO, IL
ZIP 60625
Phone: (773) 784-6300
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MODERN OPTICAL EYEWEAR, INC. is an eyewear supplier in Chicago, IL. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. MODERN OPTICAL EYEWEAR, INC. NPI is 1346384450. The provider is registered as an organization entity type.

The provider's business location address is:

2812 W FOSTER AVE
CHICAGO, IL
ZIP 60625-506
Phone: (773) 784-6300
Fax: (773) 360-9589

The provider's authorized official is John Maniatakis .
The authorized official title is Owner and has the following contact phone number (773) 784-6300.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 4/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear Supplier332H00000XILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10722440001MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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