Bouchard, Charles

Bouchard, Charles is an individual health care provider with primary practice located at 2160 S First Ave (17W740 22Nd Street, Oakbrook Terrace, Il. 60181), Maywood IL 60153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bouchard, Charles can be contacted via phone (630) 627-7399.

Contact Information

Primary practice address
2160 S First Ave (17W740 22Nd Street, Oakbrook Terrace, Il. 60181) Maywood IL 60153
Phone: (630) 627-7399
Fax: (630) 627-7079
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 36080233 Illinois

Profile Details

NPI number 1902872393
LBN Legal business name Bouchard, Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Oct 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902872393 NPPES
Illinois MEDICAID 36080233

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