MEDICARE: JEFFREY T. CARON, P.C.

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	332H00000X	Eyewear Supplier	46008157	IL

General Provider Information

NPI Number	:	1831350404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY T. CARON, P.C.

Provider Business Mailing Address
First Line	:	318 W MAIN ST. STE.2
Second Line	:
City	:	GENOA
State	:	IL
Zip	:	60135-5402
Country	:	US
Telephone Number	:	815-784-6480
Fax Number	:	815-784-4604

Provider Business Practice Location Address
First Line	:	318 W MAIN ST
Second Line	:
City	:	GENOA
State	:	IL
Zip	:	60135-5402
Country	:	US
Telephone Number	:	815-784-6480
Fax Number	:	815-784-4604

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY T CARON
Credential	:	OD
Telephone Number	:	815-784-6480

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	03/11/2021

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