Individual
DR. EMILY ELLEN SKIBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4200 ILBERRY RD, MOUNT VERNON, IL 62864-6748
(618) 242-6338
(618) 242-0465
Mailing address
4200 ILBERRY RD, MOUNT VERNON, IL 62864-6748
(618) 242-6338
(618) 242-0465
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.009973
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009973
—
IL
01
—
P00650602 CA2196
MEDICARE RAILROAD
IL
Enumeration date
07/02/2007
Last updated
03/17/2015
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