Organization
MOLENAAR EYECARE SPECIALISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON WESLEY MOLENAAR OD (OWNER)
(708) 474-0078
Entity
Organization
Contact information
Practice address
3546 RIDGE ROAD, LANSING, IL 60438
(708) 474-0078
(708) 474-0141
Mailing address
3546 RIDGE ROAD, LANSING, IL 60438
(708) 474-0078
(708) 474-0141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410037747
RAILROAD MEDICARE
IL
Enumeration date
09/20/2006
Last updated
05/23/2008
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