Provider Demographics
NPI:1851373815
Name:BEGLEY, CHRISTINE J (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:J
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:J
Other - Last Name:LOCHHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1200 W DEYOUNG ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-4437
Mailing Address - Country:US
Mailing Address - Phone:618-993-5686
Mailing Address - Fax:618-997-6250
Practice Address - Street 1:374 E. GRAND AVE,
Practice Address - Street 2:BLDG 269, ROOM 140A C/O STUDENT HEALTH CTR.
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3962
Practice Address - Country:US
Practice Address - Phone:618-549-0615
Practice Address - Fax:618-457-0157
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0469370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00237399OtherMEDICARE RAILROAD
ILP00319429OtherMEDICARE RAILROAD
ILK17138Medicare PIN
ILU86088Medicare UPIN
ILK17142Medicare PIN
ILP00319429OtherMEDICARE RAILROAD
ILP00237399OtherMEDICARE RAILROAD
ILK17139Medicare PIN