Provider Demographics
NPI:1609832153
Name:RIMBERGAS, SYLVIA V (OD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:V
Last Name:RIMBERGAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4857 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2265
Mailing Address - Country:US
Mailing Address - Phone:815-399-0599
Mailing Address - Fax:815-399-2499
Practice Address - Street 1:102 S HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-3083
Practice Address - Country:US
Practice Address - Phone:815-288-7711
Practice Address - Fax:815-285-8901
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U85171Medicare UPIN