Provider Demographics
NPI:1275156341
Name:ROSIN OPTICAL CO. INC.
Entity Type:Organization
Organization Name:ROSIN OPTICAL CO. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CHIARAMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-546-8319
Mailing Address - Street 1:6233 CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2370
Mailing Address - Country:US
Mailing Address - Phone:708-749-2020
Mailing Address - Fax:
Practice Address - Street 1:9400 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2326
Practice Address - Country:US
Practice Address - Phone:708-598-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-24
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7114393Medicaid