MEDICARE: DR. MICHAEL BRIAN SEHY OD

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	152WL0500X	Low Vision Rehabilitation Optometrist	046.008807	IL
2	152W00000X	Optometrist	046.008807	IL

General Provider Information

NPI Number	:	1831253582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BRIAN SEHY OD

Provider Business Mailing Address
First Line	:	303 N KELLER DR
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-1859
Country	:	US
Telephone Number	:	217-342-2367
Fax Number	:	217-342-2681

Provider Business Practice Location Address
First Line	:	118 W WASHINGTON AVE
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2354
Country	:	US
Telephone Number	:	217-342-2367
Fax Number	:	217-342-2681

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	11/13/2018

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