Burggraf, Randall D
Burggraf, Randall D is an sole proprietor health care provider with primary practice located at 500 S 3Rd St Suite 105, Geneva IL 60134-2762. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burggraf, Randall D can be contacted via phone (630) 232-7800.Contact Information
Primary practice address
500 S 3Rd St Suite 105
Geneva IL 60134-2762
Phone: (630) 232-7800
Fax: (630) 232-7819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046-006713 | Illinois |
Profile Details
| NPI number | 1447318563 |
|---|---|
| LBN Legal business name | Burggraf, Randall D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jan 15th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447318563 | NPPES |
| Illinois | MEDICAID | 046006713 |
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