MEDICARE: LINDSEY B RECTOR 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	152W00000X	Optometrist	OPT.2359	SC
2	152W00000X	Optometrist	046.011742	IL

General Provider Information

NPI Number	:	1881325496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY B RECTOR OD

Provider Business Mailing Address
First Line	:	540 W NORTH ST STE 209
Second Line	:
City	:	MANHATTAN
State	:	IL
Zip	:	60442-8202
Country	:	US
Telephone Number	:	815-478-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 W NORTH ST STE 209
Second Line	:
City	:	MANHATTAN
State	:	IL
Zip	:	60442-8202
Country	:	US
Telephone Number	:	815-478-0100
Fax Number	:

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

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	08/08/2023

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