Provider Demographics
NPI:1023241569
Name:MULDER, ANDREW JOHN (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:MULDER
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1255 E OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8539
Mailing Address - Country:US
Mailing Address - Phone:331-305-6556
Mailing Address - Fax:331-305-6559
Practice Address - Street 1:225 N MICHIGAN AVE
Practice Address - Street 2:LENSCRAFTERS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601
Practice Address - Country:US
Practice Address - Phone:312-819-0199
Practice Address - Fax:312-819-0397
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2021-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL046010270152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist