Individual
JEFFREY A HUETTEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
1607 VISA DR, SUITE 4, NORMAL, IL 61761-2137
(309) 454-2472
(309) 454-3029
Mailing address
1607 VISA DR, SUITE 4, NORMAL, IL 61761-2137
(309) 454-2472
(309) 454-3029
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46-008558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008558
—
IL
Enumeration date
11/13/2006
Last updated
06/06/2008
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