Individual
EMILY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Mailing address
904 W SPRINGFIELD RD, TAYLORVILLE, IL 62568-1213
(217) 287-2020
(217) 824-2228
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009974
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009974
—
IL
01
—
0814870001
MEDICARE NSC NUMBER
IL
01
—
0814870027
MEDICARE NSC NUMBER
IL
01
—
0814870028
MEDICARE NSC NUMBER
IL
01
—
0814870029
MEDICARE NSC NUMBER
IL
01
—
0814870032
MEDICARE NSC NUMBER
IL
01
—
135537
HEALTH ALLIANCE
—
01
—
IL9974
EYEMED
—
01
—
P00454765, CB9582
MEDICARE RAILROAD
IL
Enumeration date
07/18/2007
Last updated
11/12/2018
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