Dolton Optometric Center, P.C.
Organization Active NPI Medical Specialty Clinic/Center · Dolton, IL
NPI 1205957149 · NPPES record last updated Feb 11, 2010
Key facts
- NPI
- 1205957149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- 046-0074685 (IL)
- Legal business name
- DOLTON OPTOMETRIC CENTER, P.C.
- Practice address
- 14223 Chicago Rd
Dolton, IL 60419-1203 - Phone
- (708) 849-0690
- Fax
- (708) 849-0344
- NPI assigned
- Apr 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. James B Levinson, O.D., F.A.A.O.
- Title
- President
- Phone
- (708) 849-0690
Practitioners 1
-
James B Levinson, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071101000727 | IL | Part B Supplier - Clinic/Group Practice | 0042307373 |
Receives reassigned benefits from 1 practitioner Practice locations: Dolton, IL |
National Provider Directory
Locations
14223 Martin Luther King Jr Dr
Dolton, IL 60419
Phone (708) 849-0690
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 046-0074685 | IL | Yes |
Addresses
Primary practice location
14223 Chicago Rd
Dolton, IL 60419-1203
Mailing address
14223 Chicago Rd
Dolton, IL 60419-1203
Phone (708) 849-0690
Other providers in Dolton, IL
- Sonji Dixon
- Dolton Healthcare & Rehabilitation Centre,LLC
- Dolton Medical Associates
- Dolton Nursing & Rehab, LLC
- Dolton Nursing & Rehab, LLC
- Trina Lavon Downs
- Dr. David E. Miller & Associates, P.C.
- Dr. Isaacs & Dr. Silverglade, LTD
- Qiana Nicole Dukes
- Edwards Transportation Inc
All providers in Dolton, IL · Medical Specialty Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.