Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ANDREW W. BACKUS, O.D.
Deactivated Sole ProprietorDR. ANDREW W. BACKUS, O.D. is a Optometrist healthcare provider located in BLOOMINGTON, Illinois. NPI 1336131259 is deactivated in the NPPES registry. Verify at CMS.
Optometrist · BLOOMINGTON, IL
This NPI has been deactivated.
The record was deactivated on March 23, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1336131259
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 17, 2005 (0.5972602739726 yrs)
- Last Updated
- Aug 11, 2014
- Deactivated
- Mar 23, 2006
- License
-
046-006702 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6 HEARTLAND DRSUITE CBLOOMINGTON, IL, 617047736Browse IL providers · Browse ZIP 61704
- Phone
- 3096630303
- Fax
- 3096630161
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in BLOOMINGTON, IL
| Name | Credential | NPI |
|---|---|---|
| DR. DENNIS M BRTVA | O.D. | 1215909056 |
| SHAWN M KOEHLER | O.D. | 1336180876 |
| THOMAS L MAHAFFEY | OD | 1669401139 |
| DR. WILSON W. MOVIC | O.D. | 1194730648 |
| DR. JAY E TALLIS | OD | 1083627830 |
| DR. JOHN FRANCIS COUILLARD | O.D. | 1053404780 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.