Individual
LINDA L MAHAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1700 PARKWAY PLAZA DR STE 4, NORMAL, IL 61761
(309) 454-2233
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 306-9001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008624
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008624
—
IL
Enumeration date
06/23/2006
Last updated
10/25/2018
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