JULIAN LARA (NPI# 1205354883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205354883 |
| Entity Type | Individual |
| Full Name | JULIAN LARA |
| Credential | COA |
| Practice Address |
550 E Boughton Rd Ste 120 Bolingbrook IL 60440-2193 |
| Mailing Address |
9813 S Keeler Ave Apt D Oak Lawn IL 60453-3474 |
| Practice Telephone | 6307839960 |
| Mailing Telephone | 7732904157 |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1101X |
Technician/Technologist Specialization: Ophthalmic Assistant |
Eye and Vision Services Providers |
| Street Address |
550 E BOUGHTON RD STE 120 |
| City | BOLINGBROOK |
| State | IL |
| Zip Code | 60440-2193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1851949150 | Rachel Nicole Weis | Student in an Organized Health Care Education/Training Program | 777 Falconridge Way, Bolingbrook, IL 60440 | 2019-08-29 |
| 1578072815 | Onna Ford-kendrick | Nurse Practitioner | 151 E. Briarcliff Rd, -, Bolingbrook, IL 60440 | 2017-09-28 |
| 1891245213 | Megan Lotarski | Specialist/Technologist | 6 Copper Ct, Bolingbrook, IL 60440 | 2016-10-10 |
| 1144775800 | Mitchell Quill | Chiropractor | 550 E Boughton Rd Ste 150, Bolingbrook, IL 60440 | 2016-08-23 |
| 1477914125 | Alessia L. Elerby | Specialist | 128 S Cass Ave, Westmont, IL 60440 | 2016-03-09 |
| 1982073821 | Melissa Perkins | Counselor | 511 Preston Drive, Bolingbrook, IL 60440 | 2015-09-22 |
| 1821467754 | Advanced Patient Care, LLC. | Pharmacy | 335-337 Remington Blvd., Bolingbrook, IL 60440 | 2015-09-22 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1467864512 | Alice II Salons | Specialist | 311 Quadr,., Bolingbrook, IL 60440 | 2014-05-23 |
| Find all providers in zip 60440 | ||||
| Taxonomy Code | 156FX1101X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ophthalmic Assistant |
| Definition to come... |
| City | BOLINGBROOK |
| Zip Code | 60440 |
Please comment or provide details below to improve the information on JULIAN LARA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.