Derek Hennig, OD

NPI #1215466008 in Charleston, Illinois

Provider Information

NPI Number: 1215466008
Entity Type: Individual
Name: Derek Hennig, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jun 6, 2017
Last Updated: Jun 6, 2017

Practice Location

Address: 1700 18TH ST
City: Charleston
State: Illinois
ZIP Code: 61920-3607
Phone: (217) 345-6600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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