Penny R Brown
Individual provider Active NPI Optician · Galesburg, IL
NPI 1295726248 · NPPES record last updated Jan 30, 2008
Key facts
- NPI
- 1295726248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- Practice address
- 430 N Henderson St
Ste a
Galesburg, IL 61401-3596 - Phone
- (309) 342-8676
- Fax
- (309) 342-8676
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Focus Optical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Yes |
Addresses
Primary practice location
430 N Henderson St
Ste a
Galesburg, IL 61401-3596
Mailing address
430 N Henderson St
Ste a
Galesburg, IL 61401-3596
Phone (309) 342-8676
Other providers in Galesburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.