| |
719 Lincoln Ave, Rochelle, IL 61068-1867 | |
(815) 562-6175 | |
(815) 562-5037 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 719 Lincoln Ave, Rochelle, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1760689814 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 047.933091 (Illinois) | Primary |
Provider Name | Reid Eric Mlsna |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174694343 PECOS PAC ID: 5991724825 Enrollment ID: I20051121000154 |
Provider Name | Ross W Mlsna |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457428542 PECOS PAC ID: 3173662913 Enrollment ID: I20091208000157 |
Mailing Address | Practice Location Address |
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719 Lincoln Ave, Rochelle, IL 61068-1867 Ph: (815) 562-6175 | 719 Lincoln Ave, Rochelle, IL 61068-1867 Ph: (815) 562-6175 |
Dr. Reid E Mlsna, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 719 Lincoln Ave, Rochelle, IL 61068 Phone: 815-562-6175 Fax: 815-562-5037 |