Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 036070377 | IL |
NPI | 1003811787 |
---|---|
Provider Name | David S Springer |
First Address | Oak Park, IL 60302-2510 |
Second Address | Oak Park, IL 60302-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 24/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0031600193 | BLUE SHIELD (01) | IL |
036070377 | (05) | IL |
180032727 | RAILROAD MEDICARE (01) | IL |
D16724 | (02) | IL |
K44948 | MEDICARE PROVIDER NUMBER (01) | IL |