Individual
BYRON WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3700 W 203RD ST STE 310, OLYMPIA FIELDS, IL 60461-1182
(708) 679-2066
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008281
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008281
—
IL
01
—
4673170001
DMERC
IL
01
—
IL5686017
MEDICARE PTAN
IL
01
—
P00005838/CK6882
RAILROAD MEDICARE
IL
Enumeration date
07/18/2006
Last updated
12/15/2021
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