Provider Demographics
NPI:1497857213
Name:FARON, JAMES F (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:FARON
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:P.O. BOX 6002
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61803-6002
Mailing Address - Country:US
Mailing Address - Phone:217-326-8300
Mailing Address - Fax:
Practice Address - Street 1:602 W. UNIVERSITY AVENUE
Practice Address - Street 2:OPHTHALMOLOGY/OPTOMETRY
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801
Practice Address - Country:US
Practice Address - Phone:217-383-3150
Practice Address - Fax:217-383-4645
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0533210001OtherDMERC
IL410021688OtherRAILROAD
IL6447860011Medicaid
IL410021688OtherRAILROAD
ILT38564Medicare UPIN
IL6447860011Medicaid
ILL23635Medicare PIN