Provider Demographics
NPI:1235257544
Name:MEYER, SARA JO (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:JO
Last Name:MEYER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JO
Other - Last Name:LOUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2008 ROUND BARN RD
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-3623
Mailing Address - Country:US
Mailing Address - Phone:217-355-6464
Mailing Address - Fax:217-355-6476
Practice Address - Street 1:2008 ROUND BARN RD
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-3623
Practice Address - Country:US
Practice Address - Phone:217-355-6464
Practice Address - Fax:217-355-6476
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL046008936152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist