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Organization

JUNE R. R. NICHOLS OCULARIST, LTD

Active
Other names
Ocularists, Ltd
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES P JOHNSTON BCO BADO (PRESIDENT/CEO)
(847) 803-5050
Entity
Organization

Contact information

Practice address
1767 E OAKTON ST, DES PLAINES, IL 60018-2131
(847) 803-5050
(847) 803-0806
Mailing address
1767 E OAKTON ST, DES PLAINES, IL 60018-2131
(847) 803-5050
(847) 803-0806

Taxonomy

Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
332H00000X
Eyewear Supplier
335E00000X
Prosthetic/Orthotic Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016 18522
BCBS OF ILLINOIS
IL
Enumeration date
09/20/2006
Last updated
08/14/2018
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