Provider Demographics
NPI:1447203591
Name:HOHENBARY, CHRISTY C (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:C
Last Name:HOHENBARY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2190
Mailing Address - Country:US
Mailing Address - Phone:217-347-2933
Mailing Address - Fax:217-347-2932
Practice Address - Street 1:903 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2190
Practice Address - Country:US
Practice Address - Phone:217-347-2933
Practice Address - Fax:217-347-2932
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009630152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2500068OtherBLUE CROSS
P00280064OtherRAILROAD MEDICARE
IL046009630Medicaid
U95875Medicare UPIN