Healthcare Provider Details

I. General information

NPI: 1831253582
Provider Name (Legal Business Name): MICHAEL BRIAN SEHY OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W WASHINGTON AVE
EFFINGHAM IL
62401-2354
US

IV. Provider business mailing address

303 N KELLER DR
EFFINGHAM IL
62401-1859
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-2367
  • Fax: 217-342-2681
Mailing address:
  • Phone: 217-342-2367
  • Fax: 217-342-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number046.008807
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046.008807
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: