Provider Demographics
NPI:1417479569
Name:CENTRAL-HIGGINS OPTOMETRICS INC.
Entity Type:Organization
Organization Name:CENTRAL-HIGGINS OPTOMETRICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-230-5517
Mailing Address - Street 1:4920 N CENTRAL AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2341
Mailing Address - Country:US
Mailing Address - Phone:773-777-6615
Mailing Address - Fax:773-777-0177
Practice Address - Street 1:4920 N CENTRAL AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2341
Practice Address - Country:US
Practice Address - Phone:773-777-6615
Practice Address - Fax:773-777-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty