Provider Demographics
NPI:1881812162
Name:DR NEIL W MARGOLIS OD PC
Entity type:Organization
Organization Name:DR NEIL W MARGOLIS OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-255-1040
Mailing Address - Street 1:3250 N. ARLINGTON HEIGHTS RD.
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4767
Mailing Address - Country:US
Mailing Address - Phone:847-255-1040
Mailing Address - Fax:847-506-0843
Practice Address - Street 1:3250 N. ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1534
Practice Address - Country:US
Practice Address - Phone:847-255-1040
Practice Address - Fax:847-506-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X152WV0400X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP15737Medicare PIN
ILP15738Medicare PIN
ILT36679Medicare UPIN
ILT36680Medicare UPIN
IL0481670001Medicare NSC