# NORTH SHORE EYE AND VASCULAR SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013342401
- **Authorized official:** DOMINIC TOLITANO M.D. (OWNER)
- **Authorized official phone:** (847) 590-1500

## Contact information

- **Practice address:** 236 E IRVING PARK RD, WOOD DALE, IL 60191-2099
- **Practice address phone:** (847) 590-1500
- **Practice address fax:** (847) 590-1502
- **Mailing address:** 236 E IRVING PARK RD, WOOD DALE, IL 60191-2099
- **Mailing address phone:** (847) 590-1500
- **Mailing address fax:** (847) 590-1502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036049793 | IL | Yes |
| 2086S0129X | Vascular Surgery Physician | 036067328 | IL | — |

## Other

- **Enumeration date:** 09/05/2013
- **Last updated:** 09/05/2013