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General NPI Number Information
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NPI Number | 1487779658
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Entity Type | Individual
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Provider Name | SUE A FEATHER O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 829 W JACKSON ST
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City | MORTON
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State | IL
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Zip | 61550-1569
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Country | US
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Telephone | 309-266-8881
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Fax |
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Provider Business Mailing Address
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Address Line | 829 W JACKSON ST
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City | MORTON
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State | IL
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Zip | 61550-1569
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Country | US
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Telephone | 309-266-8881
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046008588
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4078T
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1763
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License Number State | CO
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