Individual
DR. DEBRA HALL
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
046-009755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009755
—
IL
01
—
0814870001
MEDICARE NSC NUMBER
IL
01
—
0814870003
MEDICARE NSC NUMBER
IL
01
—
0814870004
MEDICARE NSC NUMBER
IL
01
—
0814870005
MEDICARE NSC NUMBER
IL
01
—
0814870009
MEDICARE NSC NUMBER
IL
01
—
107333
HEALTH ALLIANCE
—
01
—
410828
HARMONY HEALTH PLAN
—
01
—
IL9755
EYEMED
—
01
—
P00260857, CA2196
MEDICARE RAILROAD
IL
Enumeration date
05/16/2006
Last updated
10/01/2008
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