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General NPI Number Information
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NPI Number | 1972473155
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Entity Type | Organization
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Legal Business Name | TRENTON EYE CARE, PLLC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 409 E BROADWAY
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City | TRENTON
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State | IL
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Zip | 62293-1663
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Country | US
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Telephone | 618-224-0078
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Fax |
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Provider Business Mailing Address
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Address Line | 409 E BROADWAY
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City | TRENTON
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State | IL
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Zip | 62293-1663
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Country | US
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Telephone | 618-224-0078
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. THERESA ANN HAAS
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Credential | OD
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Telephone | 618-224-0078
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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 |
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License Number State |
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