Basic Information
| Provider Information | |||||||||
| NPI: | 1184847386 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOFINSKI | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 S LOUIS ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600563450 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 239 GOLF MILL CTR STE 255 | ||||||||
| Address2: | |||||||||
| City: | NILES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607145658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472972286 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 05/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046-008267 | IL | N | Eye and Vision Services Providers | Optometrist | 152W00000X | TPOP19 | FL | N | Eye and Vision Services Providers | Optometrist | 152WC0802X | 046-008267 | IL | N | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152WP0200X | 046-008267 | IL | N | Eye and Vision Services Providers | Optometrist | Pediatrics | 152WS0006X | 046-008267 | IL | N | Eye and Vision Services Providers | Optometrist | Sports Vision | 152WX0102X | 046-008267 | IL | N | Eye and Vision Services Providers | Optometrist | Occupational Vision | 152W00000X | 2332 | WI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.