Provider Demographics
NPI:1912044439
Name:HSIUE, ANNE (OD)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:HSIUE
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 1:958 STONEFIELD LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2591
Mailing Address - Country:US
Mailing Address - Phone:708-674-7389
Mailing Address - Fax:
Practice Address - Street 1:7151 WALTON ST.
Practice Address - Street 2:SAM'S CLUB OPTICAL
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2591
Practice Address - Country:US
Practice Address - Phone:815-397-4704
Practice Address - Fax:815-397-4812
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009462152W00000X
IL046-009462152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist