MEDICARE: SEAN PATRICK O'NEILL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	02220	IA

General Provider Information

NPI Number	:	1124165089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN PATRICK O'NEILL O.D.

Provider Business Mailing Address
First Line	:	421 WHISPERING WILLOW LN
Second Line	:
City	:	SOLON
State	:	IA
Zip	:	52333-9448
Country	:	US
Telephone Number	:	319-624-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1614 SYCAMORE ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6044
Country	:	US
Telephone Number	:	319-337-3737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	10/30/2013

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