Organization
BERGH-WHITE OPTICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH F WHITE (VICE PRESIDENT)
(217) 787-8700
Entity
Organization
Contact information
Practice address
2351 W MONROE ST, SPRINGFIELD, IL 62704-1452
(217) 787-8700
(217) 787-8707
Mailing address
2351 W MONROE ST, SPRINGFIELD, IL 62704-1452
(217) 787-8700
(217) 787-8707
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046008999
IL
152W00000X
Optometrist
046009181
IL
152WV0400X
Vision Therapy Optometrist
Primary
046008999
IL
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
12/12/2006
Last updated
05/17/2010
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