Healthcare Provider Details

I. General information

NPI: 1912371071
Provider Name (Legal Business Name): RAJINDER KAUR O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2015
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E OGDEN AVE
NAPERVILLE IL
60563-2832
US

IV. Provider business mailing address

2495 ANGELA LN
AURORA IL
60502-9068
US

V. Phone/Fax

Practice location:
  • Phone: 630-778-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046.010957
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: