| |
500 Lincoln Dr, Suite A, Herrin, IL 62948-6334 | |
(618) 351-8900 | |
(618) 351-0076 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 500 Lincoln Dr, Herrin, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144387333 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Illinois) | Secondary |
207W00000X | Ophthalmology | (Illinois) | Primary |
Mailing Address | Practice Location Address |
---|---|
2800 W Main St, Carbondale, IL 62901-1087 Ph: (618) 351-8900 | 500 Lincoln Dr, Suite A, Herrin, IL 62948-6334 Ph: (618) 351-8900 |