Healthcare Provider Details

I. General information

NPI: 1770572620
Provider Name (Legal Business Name): MARY TERESA FRANEY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY TERESA RIEGER OD

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 KAYS DR
NORMAL IL
61761-1958
US

IV. Provider business mailing address

407 KAYS DR STE A
NORMAL IL
61761-1958
US

V. Phone/Fax

Practice location:
  • Phone: 309-320-2020
  • Fax: 309-408-3604
Mailing address:
  • Phone: 309-320-2020
  • Fax: 309-408-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046-008997
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number046-008997
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number046-008997
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: