Provider Demographics
NPI:1003059015
Name:DR. KAREN S. CYCOTTE,O.D.,LLC
Entity Type:Organization
Organization Name:DR. KAREN S. CYCOTTE,O.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:CYCOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-433-0282
Mailing Address - Street 1:849 U.S. HWY 51 S.
Mailing Address - Street 2:STE B & C
Mailing Address - City:FORSYTH
Mailing Address - State:IL
Mailing Address - Zip Code:62535-9759
Mailing Address - Country:US
Mailing Address - Phone:217-875-7002
Mailing Address - Fax:217-875-7036
Practice Address - Street 1:849 U.S. HWY 51 S.
Practice Address - Street 2:STE B & C
Practice Address - City:FORSYTH
Practice Address - State:IL
Practice Address - Zip Code:62535-9759
Practice Address - Country:US
Practice Address - Phone:217-875-7002
Practice Address - Fax:217-875-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty