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Contact Information

THEODORE E BOGART, OD
WEST ROUTE 16
SHELBYVILLE, IL62565-0199
 Phone: 217-774-4422
 Fax: 217-774-4722
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for THEODORE E BOGART · (Male)

NPI # 1609950401
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/25/2006
Last updated 12/19/2012 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 046007165
  • IL Medicaid 046007165
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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