Provider Demographics
NPI:1801904909
Name:GREENSPAN-WEISZ VISION SPECIALISTS LTD
Entity type:Organization
Organization Name:GREENSPAN-WEISZ VISION SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GREENSPAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD PHD
Authorized Official - Phone:847-763-9760
Mailing Address - Street 1:9150 CRAWFORD AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1770
Mailing Address - Country:US
Mailing Address - Phone:847-763-9760
Mailing Address - Fax:847-763-9762
Practice Address - Street 1:9150 CRAWFORD AVE
Practice Address - Street 2:CHURCH CRAWFORD MEDICAL BUILDING SUITE 205
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1770
Practice Address - Country:US
Practice Address - Phone:847-763-9760
Practice Address - Fax:847-763-9762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K15716Medicare UPIN
211238Medicare ID - Type Unspecified