Individual
DR. BRIAN BOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2537 PLAINFIELD RD, JOLIET, IL 60435-1463
(815) 577-2020
(815) 577-0998
Mailing address
2537 PLAINFIELD RD, JOLIET, IL 60435-1463
(815) 577-2020
(815) 577-0998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009118
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009919581
BLUE CROSS BLUE SHIELD IL
IL
05
—
046009118
—
IL
01
—
1457618621
AETNA
IL
Enumeration date
05/20/2006
Last updated
08/05/2013
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