Individual
TYSON J HERRMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
304 W HAY ST, SUITE 311, DECATUR, IL 62526-6328
(217) 698-3030
(217) 698-4728
Mailing address
1104 N VERMILION ST, DANVILLE, IL 61832-3094
(217) 442-2631
(217) 442-0119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009537
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009537
—
IL
01
—
180022789
RR MEDICARE
IL
Enumeration date
06/08/2006
Last updated
03/25/2025
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