Susan M Penner

NPI #1194917971 in Byron, Illinois

Provider Information

NPI Number: 1194917971
Entity Type: Organization
Organization Name: Susan M Penner
Subpart: Yes (part of a larger organization)
Parent Organization: SUSAN M PENNER
Primary Specialty: Optometrist
Enumeration Date: Aug 15, 2007
Last Updated: Aug 15, 2007

Practice Location

Address: 134 E BLACKHAWK DR
City: Byron
State: Illinois
ZIP Code: 61010-8610
Phone: (815) 234-2020

Authorized Official

Name: DR. SUSAN M PENNER, O.D.
Title: OWNER
Phone: (815) 234-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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