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2528 N Harlem Ave, Main Floor, Elmwood Park, IL 60707-2046 | |
| (708) 456-4362 | |
| (708) 456-5161 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2528 N Harlem Ave, Elmwood Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992982169 | NPI | - | NPPES |
| 01621057 | Other | IL | BCBS |
| 046008683 | Medicaid | IL | |
| IL4407 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046008683 (Illinois) | Primary |
| Provider Name | Loretta L De Koster |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316028723 PECOS PAC ID: 0042407165 Enrollment ID: I20110113001021 |
| Mailing Address | Practice Location Address |
|---|---|
2528 N Harlem Ave, Main Floor, Elmwood Park, IL 60707-2046 Ph: (708) 456-4362 | 2528 N Harlem Ave, Main Floor, Elmwood Park, IL 60707-2046 Ph: (708) 456-4362 |
Dr. Christopher David Frame, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 7310 W North Ave, Suite 2h, Elmwood Park, IL 60707 Phone: 708-456-3232 Fax: 708-456-3371 | |
Dr. Loretta L De Koster, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2500 N. Harlem Ave, Elmwood Park, IL 60707 Phone: 708-456-4362 Fax: 708-456-5161 | |
Christopher D. Frame, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 7310 W North Ave, 2h, Elmwood Park, IL 60707 Phone: 708-456-3232 Fax: 708-456-3371 | |
Elizabeth M Panton, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 7740 W North Ave, Elmwood Park, IL 60707 Phone: 708-452-7200 | |
Dr. Stacy Elise Beute, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 7310 W North Ave Ste 2h, Elmwood Park, IL 60707 Phone: 708-456-3232 Fax: 708-456-3371 |