Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 046.009339 | IL |
NPI | 1013062868 |
---|---|
Provider Name | Dr. Rebecca A Schoepke |
First Address | Cary, IL 60013 |
Second Address | Cary, IL 60013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 29/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046009339 | (05) | IL |
MS0725020 | DEA (01) | IL |
U87188 | (02) | IL |