Provider Demographics
NPI:1801002993
Name:ROBERT B SCOTT OCULARISTS LTD
Entity Type:Organization
Organization Name:ROBERT B SCOTT OCULARISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BONNY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-782-3558
Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:SUITE 1620
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3453
Mailing Address - Country:US
Mailing Address - Phone:312-782-3558
Mailing Address - Fax:312-372-4449
Practice Address - Street 1:600 HIGGINS RD
Practice Address - Street 2:SUITE 1N
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5707
Practice Address - Country:US
Practice Address - Phone:847-698-9117
Practice Address - Fax:847-698-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0247160001Medicare ID - Type Unspecified