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Individual

DR. SARAH REBECCA BURGETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
4731 45TH STREET CT, ROCK ISLAND, IL 61201-7102
(309) 793-2020
(309) 793-2602
Mailing address
777 TANGLEFOOT LN, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 328-5694

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010509
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
977130
IL GROUP MEDICARE #
IL
05
O46010509
IL
Enumeration date
06/18/2012
Last updated
03/04/2014
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