Organization
KENNETH J. LOSSMAN, O.D., P.C.
Active
Other names
Lossman Eye Care Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH J LOSSMAN O.D. (PRESIDENT)
(847) 726-2020
Entity
Organization
Contact information
Practice address
950 W MAIN ST, SUITE 125, LAKE ZURICH, IL 60047-3417
(847) 726-2020
(847) 726-2036
Mailing address
950 WEST MAIN ST, SUITE 125, LAKE ZURICH, IL 60047
(847) 726-2020
(847) 726-2036
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006871
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356464952
—
IL
01
—
CD3263
RAILROAD MEDICARE
IL
Enumeration date
04/09/2007
Last updated
04/09/2014
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