OrganizationActive
Bolingbrook Vision Source Inc.
NPI 1902129604 · Optometrist · Bolingbrook, IL
Provider details
- NPI number
- 1902129604
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- John Gardner, Owner(708) 598-1322
- License
- 046006455 (IL)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
492 W Boughton Rd
Bolingbrook, IL 60440-1441
Phone: (630) 759-4396
Fax: (630) 759-7761
Street-level locationGet directions
Mailing address
492 W Boughton Rd
Bolingbrook, IL 60440-1441
Registry dates
- Enumerated
- 2010-03-09
- Last updated
- 2010-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.