Individual
SABRINA M SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
18 GINGER CREEK PKWY, GLEN CARBON, IL 62034-3502
(618) 656-7774
(618) 656-0536
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009802
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009802
—
IL
Enumeration date
02/05/2007
Last updated
05/20/2019
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