Organization
DR BARRY P SIEGEL OPTOMETRIST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY SIEGEL O.D. (PRESIDENT)
(773) 525-0952
Entity
Organization
Contact information
Practice address
1926 W IRVING PARK RD, CHICAGO, IL 60613-2408
(773) 525-0952
(773) 525-0966
Mailing address
1926 W IRVING PARK RD, CHICAGO, IL 60613-2408
(773) 525-0952
(773) 525-0966
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0466370
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00105852285
AETNA
IL
05
—
046-006370
—
IL
Enumeration date
05/31/2007
Last updated
06/21/2018
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