Londos, Glenn R
Londos, Glenn R is an sole proprietor health care provider with primary practice located at 1103 E 31St St , La Grange Park IL 60526-1280. He recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Londos, Glenn R can be contacted via phone (708) 588-1781.Contact Information
Primary practice address
1103 E 31St St
La Grange Park IL 60526-1280
Phone: (708) 588-1781
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046007566 | Illinois |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 046007566 | Illinois |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 046007566 | Illinois |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 046007566 | Illinois |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 046007566 | Illinois |
Profile Details
| NPI number | 1295791622 |
|---|---|
| LBN Legal business name | Londos, Glenn R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Sep 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295791622 | NPPES |
| Illinois | Other | 1684555 | BLUE CROSS BLUE SHIELD |
| Illinois | MEDICAID | 046007566 | BLUE CROSS BLUE SHIELD |
| Illinois | Other | 195546334402 | BLUE CROSS BLUE SHIELD |
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