Provider Demographics
NPI:1477541175
Name:LINDER, ORAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ORAN
Middle Name:
Last Name:LINDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4032 BLACKHAWK ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-7164
Mailing Address - Country:US
Mailing Address - Phone:309-786-9734
Mailing Address - Fax:
Practice Address - Street 1:4032 BLACKHAWK ROAD
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-7164
Practice Address - Country:US
Practice Address - Phone:309-786-9734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008291152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL410047602OtherMEDICARE RAILROAD
IL7215175OtherBCBS
IL046008291Medicaid
ILU89297Medicare UPIN
ILK04663Medicare PIN
IL0295700004Medicare NSC