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Individual

STEVEN H LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1351 HICKORY POINT DR STE B, FORSYTH, IL 62535-1085
(217) 875-3724
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9754

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007319
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046007319
IL
Enumeration date
03/21/2007
Last updated
07/21/2022
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