Provider Demographics
NPI:1619077831
Name:QUIVEY, JULIE LINN (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LINN
Last Name:QUIVEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1307 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-9770
Mailing Address - Country:US
Mailing Address - Phone:217-586-4373
Mailing Address - Fax:217-586-4373
Practice Address - Street 1:505 S NEIL ST
Practice Address - Street 2:SUITE #4
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-5231
Practice Address - Country:US
Practice Address - Phone:217-356-5787
Practice Address - Fax:217-356-0655
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management