Zajicek, Richard Mark

Zajicek, Richard Mark is an sole proprietor health care provider with primary practice located at 3141 S Veterans Pkwy , Springfield IL 62704-6565. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Zajicek, Richard Mark can be contacted via phone (217) 793-2273.

Contact Information

Primary practice address
3141 S Veterans Pkwy Springfield IL 62704-6565
Fax: (217) 793-2278
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046007387 Illinois

Profile Details

NPI number 1255479358
LBN Legal business name Zajicek, Richard Mark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Mar 7th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255479358 NPPES
Illinois Other 047933072 IL ANCILLARY LIC ALGONQUI
Illinois Other 046007387 IL ANCILLARY LIC ALGONQUI
Illinois Other 1684405 IL ANCILLARY LIC ALGONQUI
Illinois Other 346000315 IL ANCILLARY LIC ALGONQUI
Illinois Other 346002621 IL ANCILLARY LIC ALGONQUI

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