Individual
DARCY L DUZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1700 18TH ST, CHARLESTON, IL 61920-3607
(217) 345-6600
(217) 345-6622
Mailing address
1700 18TH ST, CHARLESTON, IL 61920-3607
(217) 345-6600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009869
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508886078
—
IL
01
—
1584009
BCBS PROVIDER NUMBER
IL
01
—
371219488
DMERC SUPPLIER #
IL
01
—
P00374913
RAILROAD MEDICARE
IL
Enumeration date
07/20/2006
Last updated
02/24/2012
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