Provider Demographics
NPI:1093047003
Name:GREENBERG, DAVID ARNOLD (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARNOLD
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3982 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2703
Mailing Address - Country:US
Mailing Address - Phone:773-282-2000
Mailing Address - Fax:773-282-9428
Practice Address - Street 1:3982 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2703
Practice Address - Country:US
Practice Address - Phone:773-282-2000
Practice Address - Fax:773-282-9428
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist