Healthcare Provider Details

I. General information

NPI: 1538683958
Provider Name (Legal Business Name): BOBBY RAJKUMAR SINGH OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S RAND RD
LAKE ZURICH IL
60047-2465
US

IV. Provider business mailing address

820 S RAND RD
LAKE ZURICH IL
60047-2465
US

V. Phone/Fax

Practice location:
  • Phone: 847-550-0376
  • Fax: 847-550-0398
Mailing address:
  • Phone: 847-550-0376
  • Fax: 847-550-0398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046011140
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: