Provider Demographics
NPI:1003811787
Name:SPRINGER, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:SPRINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 ERIE CT
Mailing Address - Street 2:STE 6140
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2510
Mailing Address - Country:US
Mailing Address - Phone:708-848-2400
Mailing Address - Fax:708-445-8269
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:STE 6140
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2510
Practice Address - Country:US
Practice Address - Phone:708-848-2400
Practice Address - Fax:708-445-8269
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036070377207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070377Medicaid
IL180032727OtherRAILROAD MEDICARE
ILK44948OtherMEDICARE PROVIDER NUMBER
IL0031600193OtherBLUE SHIELD
IL0031600193OtherBLUE SHIELD
IL036070377Medicaid