Provider Demographics
NPI:1982878831
Name:DR LENARD C SCHWARTZ OPTOMETRIST LTD
Entity Type:Organization
Organization Name:DR LENARD C SCHWARTZ OPTOMETRIST LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LENARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-543-0607
Mailing Address - Street 1:1250 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-5744
Mailing Address - Country:US
Mailing Address - Phone:630-543-0607
Mailing Address - Fax:630-543-5290
Practice Address - Street 1:1250 W LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-5744
Practice Address - Country:US
Practice Address - Phone:630-543-0607
Practice Address - Fax:630-543-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00152336OtherRR MEDICARE
IL509031Medicare PIN
IL0357660001Medicare NSC
IL509030Medicare PIN
T36676Medicare UPIN