Organization
BOLINGBROOK EYE SPECIALISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT RAYMOND RICHARDSON (OWNER)
(630) 968-9440
Entity
Organization
Contact information
Practice address
150 CONCORD LANE, BOLINGBROOK, IL 60440
(630) 759-1330
(630) 968-0180
Mailing address
150 CONCORD LANE, BOLINGBROOK, IL 60440
(630) 759-1330
(630) 968-0180
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007060
IL
152W00000X
Optometrist
346000246
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007060
—
IL
Enumeration date
10/16/2006
Last updated
09/16/2009
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