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Individual

MR. JAMES RANDALL BECHTOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1346 PATRIOT BLVD., GLENVIEW, IL 60025
(847) 729-5050
(224) 521-2995
Mailing address
1014 MAPLETON AVE, OAK PARK, IL 60302
(708) 386-0885
(708) 386-0695

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-009154
IL
152W00000X
Optometrist
Primary
046009154
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046-009154
IL
Enumeration date
11/20/2006
Last updated
09/23/2009
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