Funk, Todd E
Funk, Todd E is an individual health care provider with primary practice located at 100 Hillcrest Dr Ste B , Washington IL 61571-2227. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Funk, Todd E can be contacted via phone (309) 444-5188.Contact Information
Primary practice address
100 Hillcrest Dr Ste B
Washington IL 61571-2227
Phone: (309) 444-5188
Fax: (309) 444-2258
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046008264 | Illinois |
Profile Details
| NPI number | 1013914068 |
|---|---|
| LBN Legal business name | Funk, Todd E |
| Credentials | O.D., F.A.A.O. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2005 |
| Last updated | Dec 10th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013914068 | NPPES |
| Illinois | MEDICAID | 364121696-61571-01 |
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