Leahy, Timothy J

Leahy, Timothy J is an individual health care provider with primary practice located at 201 N Madison St , Pittsfield IL 62363-1447. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Leahy, Timothy J can be contacted via phone (217) 285-4800.

Contact Information

Primary practice address
201 N Madison St Pittsfield IL 62363-1447
Fax: (217) 285-4850
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2000146553 Missouri
Eye and Vision Services Providers / Optometrist 152W00000X 046008656 Illinois

Profile Details

NPI number 1629027958
LBN Legal business name Leahy, Timothy J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Feb 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629027958 NPPES
Illinois MEDICAID 1629027958
Illinois MEDICAID 1629027958

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