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NPI Code Detail

MEDICARE: DARCY L DUZAN O.D.

MEDICARE:   DARCY L DUZAN  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046009869IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00374913OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11584009OTHERILBCBS PROVIDER NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4371219488OTHERILDMERC SUPPLIER #

General Provider Information

NPI Number : 1508886078
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARCY L DUZAN O.D.
Provider Business Mailing Address
First Line : 1700 18TH ST
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-3607
Country : US
Telephone Number : 217-345-6600
Fax Number :
Provider Business Practice Location Address
First Line : 1700 18TH ST
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-3607
Country : US
Telephone Number : 217-345-6600
Fax Number : 217-345-6622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 02/24/2012

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Directions to “ DARCY L DUZAN O.D.” Practice Location

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