Basic Information
| Provider Information | |||||||||
| NPI: | 1316124621 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COTTONE FAMILY EYECARE LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6322 S ARCHER AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606382521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7735852022 | ||||||||
| FaxNumber: | 7735852027 | ||||||||
| Practice Location | |||||||||
| Address1: | 6322 S ARCHER AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606382521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7735852022 | ||||||||
| FaxNumber: | 7735852027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2008 | ||||||||
| LastUpdateDate: | 01/04/2010 | ||||||||
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| AuthorizedOfficialLastName: | COTTONE | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
| AuthorizedOfficialMiddleName: | XAVIER | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7735852022 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046007321 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.