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Organization

INDUSTRIAL OPTICAL SERVICE, INC

Active
Other names
Spex
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE ROITSTEIN O.D. (OPOMETRIST)
(312) 673-7192
Entity
Organization

Contact information

Practice address
3760 N BROADWAY ST, CHICAGO, IL 60613-4105
(773) 975-2020
Mailing address
115 S LASALLE ST, 27TH FLOOR, CHICAGO, IL 60603-3801
(312) 673-7192

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1636706
BCBS
01
7235044
AETNA
Enumeration date
11/11/2010
Last updated
02/07/2011
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