Individual
DR. TIMOTHY D. BOOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1783 S WASHINGTON ST, SUITE 111, NAPERVILLE, IL 60565-2462
(630) 961-5255
(630) 961-0335
Mailing address
367 DAFFODIL DR, ROMEOVILLE, IL 60446-5127
(815) 609-0369
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008982
IL
152W00000X
Optometrist
18002624B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932239
BCBS PROVIDER NUMBER
IL
01
—
25285
SPECTERA PROVIDER NUMBER
IL
01
—
36-4167298
VSP PROVIDER NUMBER
IL
01
—
9355873
PHCS PROVIDER ID NUMBER
IL
01
—
IL8982
EYEMED PROVIDER NUMBER
IL
Enumeration date
11/16/2006
Last updated
08/23/2012
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