Healthcare Provider Details

I. General information

NPI: 1255266482
Provider Name (Legal Business Name): SYDNEY ACKERMAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W MAIN ST
MITCHELL IN
47446-1414
US

IV. Provider business mailing address

708 S CORY LN LOT 30
BLOOMINGTON IN
47403-2008
US

V. Phone/Fax

Practice location:
  • Phone: 812-849-4555
  • Fax:
Mailing address:
  • Phone: 810-569-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18004638A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: