Provider Demographics
NPI:1184783227
Name:ADKINS, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:ADKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 E DEMPSTER ST
Mailing Address - Street 2:#206
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5316
Mailing Address - Country:US
Mailing Address - Phone:847-827-0666
Mailing Address - Fax:847-827-6247
Practice Address - Street 1:2434 E DEMPSTER ST
Practice Address - Street 2:#206
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5316
Practice Address - Country:US
Practice Address - Phone:847-827-0666
Practice Address - Fax:847-827-6247
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001670211OtherBLUE CROSS BLUE SHIELD
IL753100OtherADVOCATE HEALTHCARE
IL0525940001Medicare ID - Type Unspecified