Park, Rachel Boram
Park, Rachel Boram is an individual health care provider with primary practice located at 219 E Cole Ave , Wheaton IL 60187-3107. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Park, Rachel Boram can be contacted via phone (306) 690-7115.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046010937 | Illinois |
Profile Details
| NPI number | 1427462431 |
|---|---|
| LBN Legal business name | Park, Rachel Boram |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2014 |
| Last updated | Mar 30th, 2020 - about 6 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 | 1427462431 | NPPES |
| Illinois | Other | P01665028 | RAILROAD MEDICARE |
| Illinois | MEDICAID | 046010937 | RAILROAD MEDICARE |
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