MEDICARE: FLAVEL J. HEYMAN

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	046007630	IL

General Provider Information

NPI Number	:	1881882819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAVEL J. HEYMAN

Provider Business Mailing Address
First Line	:	145 W CENTER ST
Second Line	:
City	:	PAXTON
State	:	IL
Zip	:	60957-1210
Country	:	US
Telephone Number	:	217-379-3121
Fax Number	:	217-379-4983

Provider Business Practice Location Address
First Line	:	145 W CENTER ST
Second Line	:
City	:	PAXTON
State	:	IL
Zip	:	60957-1210
Country	:	US
Telephone Number	:	217-379-3121
Fax Number	:	217-379-4983

Authorized Official
Title or Position	:	OWNER
Name	:	FLAVEL JOSEF HEYMAN
Credential	:	O.D.
Telephone Number	:	217-379-3121

Provider Enumeration Date	:	10/03/2007
Last Update Date	:	01/31/2013

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Directions to “FLAVEL J. HEYMAN ” Practice Location

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