Individual
KREY BIXBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6807 N KNOXVILLE AVE, PEORIA, IL 61614-2812
(309) 692-0000
(309) 692-8082
Mailing address
6807 N KNOXVILLE AVE, PEORIA, IL 61614-2812
(309) 692-0000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006208
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007284003
BLUE CROSS BLUE SHIELD #
IL
Enumeration date
09/15/2006
Last updated
01/21/2015
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