| |
755 E Boughton Rd, Bolingbrook, IL 60440-2250 | |
(630) 783-0225 | |
(630) 783-0225 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 755 E Boughton Rd, Bolingbrook, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659553642 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 8782, Kentwood, MI 49518-8782 Ph: (616) 455-8434 | 755 E Boughton Rd, Bolingbrook, IL 60440-2250 Ph: (630) 783-0225 |