Larson, Bruce

Larson, Bruce is an individual health care provider with primary practice located at 126 W First St , Hinsdale IL 60521-4013. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Larson, Bruce can be contacted via phone (630) 325-5200.

Contact Information

Primary practice address
126 W First St Hinsdale IL 60521-4013
Fax: (630) 325-5569
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 36066594 Illinois

Profile Details

NPI number 1932176773
LBN Legal business name Larson, Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Jul 12th, 2010 - about 16 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 1932176773 NPPES
Illinois Other L08359 MEDICARE PTAN

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