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Individual

DONALD R MARION

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2 PARK AVENUE WEST, PRINCETON, IL 61356
(815) 879-2020
(815) 879-2001
Mailing address
PO BOX 369, 2 PARK AVENUE WEST, PRINCETON, IL 61356
(815) 879-2020
(815) 879-2001

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008161
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
684000
BCBS
IL
Enumeration date
11/01/2006
Last updated
12/29/2010
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