Cogswell, Bradley R.

Cogswell, Bradley R. is an individual health care provider with primary practice located at 4663 W 95Th St , Oak Lawn IL 60453-2540. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cogswell, Bradley R. can be contacted via phone (708) 636-0600.

Contact Information

Primary practice address
4663 W 95Th St Oak Lawn IL 60453-2540
Phone: (708) 636-0600
Fax: (708) 636-0606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X Illinois

Profile Details

NPI number 1164402491
LBN Legal business name Cogswell, Bradley R.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Mar 12th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164402491 NPPES
Illinois Other 506370 MEDICARE GROUP NUMBER
Illinois Other 1265621361 MEDICARE GROUP NUMBER

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