Individual
DR. PATRICIA R BOGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
15341 W WADDELL RD STE 106, SURPRISE, AZ 85379-5169
(623) 544-7800
Mailing address
26520 NETWORK PL, CHICAGO, IL 60673-1265
(623) 537-6000
(623) 806-7210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2001022272
MO
152W00000X
Optometrist
Primary
2163
AZ
152W00000X
Optometrist
622
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9203570
—
SD
01
—
G49B00001
MEDICARE PTAN
MO
Enumeration date
05/31/2006
Last updated
10/31/2025
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