Mark E Brewer O D P C

LBN: Mark E Brewer O D P C
Mark E Brewer O D P C is an health care organization with primary practice located at 401 River Rd , East Peoria IL 61611-2082. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Mark E Brewer O D P C can be contacted via phone (309) 694-3951, or through Brewer, Mark via phone (309) 694-3951.

Contact Information

Primary practice address
401 River Rd East Peoria IL 61611-2082
Phone: (309) 694-3951
Fax: (309) 694-3751
Website:
Map and Directions
Authorized official contact:
Name: Brewer, Mark
Phone: (309) 694-3951

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046008770 Illinois

Profile Details

NPI number 1356492292
LBN Legal business name Mark E Brewer O D P C
DBA Doing business as
Authorized official Brewer, Mark
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2007
Last updated Jan 28th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356492292 NPPES
Illinois MEDICAID 046008770

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