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Individual

DR. MAUREEN RADDATZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
5 EYE CENTER DR, HARRISBURG, IL 62946-3334
(618) 252-5377
(618) 252-3028
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
046-009543
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009543
IL
01
0814870003
MEDICARE NSC NUMBER
IL
01
0814870011
MEDICARE NSC NUMBER
IL
01
0814870023
MEDICARE NSC NUMBER
IL
01
0814870030
MEDICARE NSC NUMBER
IL
01
085495
HEALTH ALLIANCE
01
237034
HARMONY HEALTH PLAN
01
IL9543
EYEMED
01
P00053904
MEDICARE RAILROAD
IL
Enumeration date
05/12/2006
Last updated
10/01/2008
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