Organization
MINK RESOURCES, LTD.
Active
Other names
Pearle Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL D BURGGRAF O.D. (DOCTOR)
(815) 756-3700
Entity
Organization
Contact information
Practice address
620 W VETERANS PKWY, YORKVILLE, IL 60560-4567
(630) 882-8401
(630) 882-8407
Mailing address
620 W VETERANS PKWY, YORKVILLE, IL 60560-4567
(630) 882-8401
(630) 882-8407
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00466713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215176
MEDICARE NUMBER
IL
Enumeration date
01/16/2007
Last updated
12/30/2010
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