Provider Demographics
NPI:1578798989
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 OF PROFESSIONAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIARAMONTI
Authorized Official - Suffix:JR
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:60402-2317
Mailing Address - Country:US
Mailing Address - Phone:708-749-2020
Mailing Address - Fax:
Practice Address - Street 1:100 W RANDOLPH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3218
Practice Address - Country:US
Practice Address - Phone:312-263-4909
Practice Address - Fax:312-263-4932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2163OtherMEDICARE RR
999575Medicare PIN
CA2163OtherMEDICARE RR