Organization
NIERMAN VISION CENTER
Active
Other names
NIERMAN VISION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SCOTT NIERMAN O.D. (OWNER)
(312) 337-1126
Entity
Organization
Contact information
Practice address
243 W NORTH AVE, CHICAGO, IL 60610-1236
(312) 337-1126
(312) 337-1609
Mailing address
243 W NORTH AVE, CHICAGO, IL 60610-1236
(312) 337-1126
(312) 337-1609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1954608
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99301
WPS SUBMITTER NUMBER
IL
01
—
IL8498
MEDICARE PTAN
IL
Enumeration date
11/09/2010
Last updated
07/29/2013
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