Mack, Harvey

Mack, Harvey is an individual health care provider with primary practice located at 2020 W Iles Ave , Springfield IL 62704-4174. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mack, Harvey can be contacted via phone (217) 698-3030.

Contact Information

Primary practice address
2020 W Iles Ave Springfield IL 62704-4174
Phone: (217) 698-3030
Fax: (217) 698-3068
Website:
Map and Directions

Health care specialties

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

Profile Details

NPI number 1386692630
LBN Legal business name Mack, Harvey
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Sep 4th, 2007 - about 19 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 1386692630 NPPES
Illinois Other P00315313 RAILROAD MEDICARE

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