Individual
DR. EMILY S RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
511 PALMYRA ST, DIXON, IL 61021
(815) 284-2020
Mailing address
511 PALMYRA ST, DIXON, IL 61021-1953
(815) 284-2020
(815) 284-8326
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010863
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046010863
—
IL
01
—
F400221463
MEDICARE
IL
Enumeration date
06/08/2015
Last updated
11/12/2024
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