Individual
DR. MARY AGNES BIGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
106 E MAIN ST, BEARDSTOWN, IL 62618-1241
(217) 323-1146
(217) 323-1156
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-4174
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
T02559
MO
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00390109
RAILROAD MEDICARE
GA
Enumeration date
09/26/2005
Last updated
09/06/2007
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