Individual
DR. ROBERT JAMES BLUMTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2020 W ILES AVE, SPRINGFIELD, IL 62704-4174
(217) 698-3030
(217) 698-3068
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007512
IL
152WC0802X
Corneal and Contact Management Optometrist
046007512
IL
152WL0500X
Low Vision Rehabilitation Optometrist
046007512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007512
—
IL
01
—
410033847
RAILROAD MEDICARE
IL
Enumeration date
06/20/2005
Last updated
02/08/2017
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