Optical Place LTD.
Organization Active NPI Optometrist · Midlothian, IL
NPI 1104995299 · NPPES record last updated Jun 14, 2011
Key facts
- NPI
- 1104995299
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 046-007825 (IL)
- Legal business name
- OPTICAL PLACE LTD.
- Practice address
- 4716 147TH St
Midlothian, IL 60445-2527 - Phone
- (708) 597-6550
- Fax
- (708) 597-5975
- NPI assigned
- Nov 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Thomas E Hines, O.D.
- Title
- President
- Phone
- (708) 597-6550
National Provider Directory
Locations
4401 W 63rd St
Chicago, IL 60629
Phone (773) 838-8245
4716 147th St
Midlothian, IL 60445
Phone (708) 597-6550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 046-007825 | IL | Yes |
Addresses
Primary practice location
4716 147TH St
Midlothian, IL 60445-2527
Mailing address
4716 147TH St
Midlothian, IL 60445-2527
Phone (708) 597-6550
Other providers in Midlothian, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.