Provider Demographics
NPI:1831253582
Name:SEHY, MICHAEL BRIAN (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:SEHY
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 1:303 N KELLER DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-1859
Mailing Address - Country:US
Mailing Address - Phone:217-342-2367
Mailing Address - Fax:217-342-2681
Practice Address - Street 1:118 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2354
Practice Address - Country:US
Practice Address - Phone:217-342-2367
Practice Address - Fax:217-342-2681
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.008807152WL0500X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211570Medicare ID - Type Unspecified
ILU64163Medicare UPIN