Basic Information
| Provider Information | |||||||||
| NPI: | 1093194433 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OSSIP MANAGEMENT SOLUTIONS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9795 CROSSPOINT BLVD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462563354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172546480 | ||||||||
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| Practice Location | |||||||||
| Address1: | 151 MCHENRY RD | ||||||||
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| City: | BUFFALO GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600891796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474596626 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 05/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | DABELOW | ||||||||
| AuthorizedOfficialFirstName: | RYAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE AND INSURANCE | ||||||||
| AuthorizedOfficialTelephone: | 3172546480 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046006885 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.