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ROBERT A LARSON OD PC NPI 1881883585


NPI Information

NPI: 1881883585
Provider Name: ROBERT A LARSON OD PC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
15420 S RTE 59
PLAINFIELD, IL
ZIP 60544
Phone: (815) 436-8955
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ROBERT A LARSON OD PC is a clinic center in Plainfield, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ROBERT A LARSON OD PC NPI is 1881883585. The provider is registered as an organization entity type.

The provider's business location address is:

15420 S RTE 59
PLAINFIELD, IL
ZIP 60544-984
Phone: (815) 436-8955
Fax: (815) 496-8745

The provider's authorized official is Robert Aric Larson .
The authorized official title is Owner and has the following contact phone number (815) 436-8955.

The enumeration date for this NPI number is 10/18/2007 and was last updated on 10/17/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10142300001OTHERILLINOISPTAN
20142300001MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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