Organization
INDUSTRIAL OPTICAL SERVICE INC
Active
Other names
Spex
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE ROITSTEIN O.D. (OPTOMETRIST)
(312) 673-7192
Entity
Organization
Contact information
Practice address
4418 W DIVERSEY AVE, CHICAGO, IL 60639-1924
(773) 736-6800
Mailing address
4418 W DIVERSEY AVE, CHICAGO, IL 60639-1924
(773) 736-6800
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008138
—
IL
05
—
046008974
—
IL
05
—
046009268
—
IL
05
—
046009721
—
IL
05
—
046009870
—
IL
01
—
1636706
BCBS
IL
01
—
7235044
AETNA
IL
Enumeration date
09/28/2006
Last updated
11/05/2012
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