# CHICAGO OPHTHALMOLOGY, P.C.

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

## Provider details

- **NPI number:** 1275653263
- **Authorized official:** DR. GREGORY STEVEN DOREN M.D. (PRESIDENT)
- **Authorized official phone:** (773) 935-2800

## Contact information

- **Practice address:** 3000 N HALSTED ST, SUITE 501, CHICAGO, IL 60657-5188
- **Practice address phone:** (773) 935-2800
- **Practice address fax:** (773) 935-2861
- **Mailing address:** 3000 N HALSTED ST, SUITE 501, CHICAGO, IL 60657-5188
- **Mailing address phone:** (773) 935-2800
- **Mailing address fax:** (773) 935-2861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | IL | Yes |

## Other

- **Enumeration date:** 03/31/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000001274 | FAMILY MEDICAL NETWORK ID | IL |
| 01 | — | 01620224 | BCBS ID NUMBER | IL |
| 01 | — | 146050551101 | HUMANA ID \# | IL |
| 01 | — | 5237392 | AETNA ID \# | IL |
| 01 | — | P00266736 | RAILROAD MEDICARE ID \# | IL |