Londos, Glenn R

Londos, Glenn R is an sole proprietor health care provider with primary practice located at 1103 E 31St St , La Grange Park IL 60526-1280. He recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Londos, Glenn R can be contacted via phone (708) 588-1781.

Contact Information

Primary practice address
1103 E 31St St La Grange Park IL 60526-1280
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046007566 Illinois
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 046007566 Illinois
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X 046007566 Illinois
Eye and Vision Services Providers / Pediatrics 152WP0200X 046007566 Illinois
Eye and Vision Services Providers / Occupational Vision 152WX0102X 046007566 Illinois

Profile Details

NPI number 1295791622
LBN Legal business name Londos, Glenn R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2006
Last updated Sep 27th, 2010 - 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 1295791622 NPPES
Illinois Other 1684555 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 046007566 BLUE CROSS BLUE SHIELD
Illinois Other 195546334402 BLUE CROSS BLUE SHIELD

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