MEDICARE: KAREN D MARCH 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		IL

General Provider Information

NPI Number	:	1255489878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN D MARCH O.D.

Provider Business Mailing Address
First Line	:	220 AUTUMN PINE DR
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-2960
Country	:	US
Telephone Number	:	618-334-5173
Fax Number	:	618-632-2966

Provider Business Practice Location Address
First Line	:	134 SAINT CLAIR SQ
Second Line	:	#271-#272
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-2135
Country	:	US
Telephone Number	:	618-632-2204
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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