Organization
MULFORD EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD EVANS ANDERSON OD OPTOMETRIST (MEMBER)
(815) 282-5500
Entity
Organization
Contact information
Practice address
4301 N MULFORD RD, LOVES PARK, IL 61111
(815) 282-5500
(815) 633-2305
Mailing address
4301 N MULFORD RD, LOVES PARK, IL 61111
(815) 282-5500
(815) 633-2305
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010184023
BCBS
—
Enumeration date
10/23/2006
Last updated
04/08/2008
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