Individual
BRENDA HUTCHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008929
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008929
—
IL
01
—
050280
HEALTH ALLIANCE
—
01
—
0814870001
MEDICARE NSC NUMBER
IL
01
—
0814870020
MEDICARE NSC NUMBER
IL
01
—
180035690
MEDICARE RAILROAD
IL
01
—
237032
HARMONY HEALTH PLAN
—
01
—
IL8929
EYEMED
—
Enumeration date
09/30/2005
Last updated
10/01/2008
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