Provider Demographics
NPI:1437238680
Name:MUELLER, PETER F (OD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:F
Last Name:MUELLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7511 LEMONT RD
Mailing Address - Street 2:#194
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4394
Mailing Address - Country:US
Mailing Address - Phone:630-985-2202
Mailing Address - Fax:630-985-2111
Practice Address - Street 1:7511 LEMONT RD
Practice Address - Street 2:#194
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4394
Practice Address - Country:US
Practice Address - Phone:630-985-2202
Practice Address - Fax:630-985-2111
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46-007003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL928880Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER