Provider Demographics
NPI:1982859781
Name:DRS. AIDE AND ASSELL OPTOMETRISTS, PC
Entity Type:Organization
Organization Name:DRS. AIDE AND ASSELL OPTOMETRISTS, PC
Other - Org Name:IMAGE OPTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE BILLER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-301-2727
Mailing Address - Street 1:762 W EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7396
Mailing Address - Country:US
Mailing Address - Phone:847-991-3646
Mailing Address - Fax:847-991-8846
Practice Address - Street 1:762 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-7396
Practice Address - Country:US
Practice Address - Phone:847-991-3646
Practice Address - Fax:847-991-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006098152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213842Medicare UPIN