Individual
SARA R KURTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4429 16TH ST, MOLINE, IL 61265-7011
(309) 762-3937
(309) 623-6993
Mailing address
4429 16TH ST, MOLINE, IL 61265-7011
(309) 762-3937
(309) 623-6993
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009779
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009779
—
IL
01
—
0476210001
MEDICARE DME
IL
01
—
04821476
BCBS
IL
Enumeration date
02/09/2006
Last updated
07/23/2024
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