Provider Demographics
NPI:1427263946
Name:ROSIN OPTICAL CO., INC.
Entity type:Organization
Organization Name:ROSIN OPTICAL CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROFESSIONAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIARAMONTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:630-546-8319
Mailing Address - Street 1:1917 CHERRY LANE
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-564-2020
Mailing Address - Fax:847-564-2064
Practice Address - Street 1:1917 CHERRY LANE
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-564-2020
Practice Address - Fax:847-564-2064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSIN OPTICAL CO., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-10
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2163OtherMEDICARE RR
IL0452870010Medicare NSC
IL999570Medicare PIN