Robert James Berkshire Jr., O.D.
Individual provider Active NPI Optometrist · Burbank, IL
NPI 1699819151 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699819151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- Practice address
- 7913 Narragansett Ave
Burbank, IL 60459-1807 - Phone
- (708) 741-5950
- Fax
- (708) 741-5951
- NPI assigned
- Feb 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-008637 | IL | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Yes |
Addresses
Primary practice location
7913 Narragansett Ave
Burbank, IL 60459-1807
Mailing address
7913 Narragansett Ave
Burbank, IL 60459-1807
Phone (708) 741-5950
Other providers in Burbank, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.