Provider Demographics
NPI:1225129000
Name:STEINER, PAUL M (OD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:STEINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62246
Mailing Address - Country:US
Mailing Address - Phone:618-664-0075
Mailing Address - Fax:618-664-0176
Practice Address - Street 1:106 S 2ND ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246
Practice Address - Country:US
Practice Address - Phone:618-664-0075
Practice Address - Fax:618-664-0176
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0384006OtherBCBS
IL0363960001Medicare NSC
IL0384006OtherBCBS
T37988Medicare UPIN