Provider Demographics
NPI:1922256239
Name:DR. SHARON ROVENSTINE, OPTOMETRIST, P.C.
Entity Type:Organization
Organization Name:DR. SHARON ROVENSTINE, OPTOMETRIST, P.C.
Other - Org Name:ASSOCIATED OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROVENSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-820-1303
Mailing Address - Street 1:4050 HEALTHWAY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8183
Mailing Address - Country:US
Mailing Address - Phone:630-820-1303
Mailing Address - Fax:630-820-1398
Practice Address - Street 1:4050 HEALTHWAY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8183
Practice Address - Country:US
Practice Address - Phone:630-820-1303
Practice Address - Fax:630-820-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-010067152W00000X, 152WC0802X, 152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty