Provider Demographics
NPI:1346383080
Name:BOBUS, JUDITH M (OD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:M
Last Name:BOBUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:363 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1325
Mailing Address - Country:US
Mailing Address - Phone:630-773-5757
Mailing Address - Fax:630-773-0165
Practice Address - Street 1:363 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1325
Practice Address - Country:US
Practice Address - Phone:630-773-5757
Practice Address - Fax:630-773-0165
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist