Burgwald, Erik Duane
Burgwald, Erik Duane is an individual health care provider with primary practice located at 1711 S Neil St , Champaign IL 61820. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burgwald, Erik Duane can be contacted via phone (217) 359-2390.Contact Information
Primary practice address
1711 S Neil St
Champaign IL 61820
Phone: (217) 359-2390
Fax: (217) 359-3180
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046008644 | Illinois |
Profile Details
| NPI number | 1689644684 |
|---|---|
| LBN Legal business name | Burgwald, Erik Duane |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Jul 31st, 2015 - about 10 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 | 1689644684 | NPPES |
| Illinois | Other | 046008649 | DPR |
| Illinois | Other | 346000884 | DPR |
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