Wayne, Eileen Marie
Wayne, Eileen Marie is an sole proprietor health care provider with primary practice located at 840 35Th Avenue Pl Suite 101, Moline IL 61265-8026. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Wayne, Eileen Marie can be contacted via phone (309) 736-0808.Contact Information
Primary practice address
840 35Th Avenue Pl Suite 101
Moline IL 61265-8026
Phone: (309) 736-0808
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036051328 | Illinois |
Profile Details
| NPI number | 1194715953 |
|---|---|
| LBN Legal business name | Wayne, Eileen Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Jun 21st, 2010 - about 16 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 | 1194715953 | NPPES |
| Illinois | MEDICAID | 036051328 | |
| Illinois | Other | 8100324 |
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