Eigenbrodt, John Robert

Eigenbrodt, John Robert is an individual health care provider with primary practice located at 1950 Edwardsville Club Plaza , Edwardsville IL 62025-3517. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Eigenbrodt, John Robert can be contacted via phone (618) 656-3199.

Contact Information

Primary practice address
1950 Edwardsville Club Plaza Edwardsville IL 62025-3517
Phone: (618) 656-3199
Fax: (618) 656-3099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046008144 Illinois

Profile Details

NPI number 1982602918
LBN Legal business name Eigenbrodt, John Robert
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Jun 3rd, 2009 - about 15 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 1982602918 NPPES
Illinois Other 5932266 AETNA
Illinois Other 06032220 AETNA
Illinois Other 203722190 AETNA
Illinois Other 203722190 AETNA
Illinois Other 274260 AETNA
Illinois Other IL8144 AETNA
Illinois Other 125215 AETNA
Illinois Other 125419 AETNA
Illinois Other POO429582 AETNA

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