Individual
CHARLES NORMAN BERTOIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
70 E LAKE ST # 107, CHICAGO, IL 60601-5959
(312) 236-3822
(312) 236-3825
Mailing address
1716 HIGHLAND AVE, WILMETTE, IL 60091-2412
(847) 707-8565
(312) 236-3825
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040031350
BCBS PROVIDER #
IL
Enumeration date
08/01/2006
Last updated
07/08/2007
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