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Individual

DR. JOHN ROBERT EIGENBRODT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1950 EDWARDSVILLE CLUB PLAZA, EDWARDSVILLE, IL 62025-3517
(618) 656-3199
(618) 656-3099
Mailing address
1950 EDWARDSVILLE CLUB PLAZA, EDWARDSVILLE, IL 62025-3517
(618) 656-3199
(618) 656-3099

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008144
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06032220
BLUE CROSS BLUE SHIELD IL
IL
01
125215
HEALTHLINK
IL
01
125419
ANTHEM BCB SHIELD MO
IL
01
203722190
UNITED HEALTH CARE
IL
01
274260
GHP
IL
01
5932266
AETNA
IL
01
IL8144
EYEMED
IL
01
POO429582
PTAN RAIL RD MEDICARE
IL
Enumeration date
07/13/2005
Last updated
06/03/2009
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