Minarik, Kenneth Ronald
Minarik, Kenneth Ronald is an individual health care provider with primary practice located at 8530 N 2Nd St , Machesney Park IL 61115-2414. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Minarik, Kenneth Ronald can be contacted via phone (815) 654-7777.Contact Information
Primary practice address
8530 N 2Nd St
Machesney Park IL 61115-2414
Phone: (815) 654-7777
Fax: (815) 654-7902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046007285 | Illinois |
Profile Details
| NPI number | 1598834293 |
|---|---|
| LBN Legal business name | Minarik, Kenneth Ronald |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Feb 15th, 2022 - about 2 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 | 1598834293 | NPPES |
| Illinois | Other | 08123272 | BCBS |
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