Provider Demographics
NPI:1124263017
Name:NORON, INC
Entity type:Organization
Organization Name:NORON, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:V
Authorized Official - Last Name:DAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:309-674-6633
Mailing Address - Street 1:456 FULTON ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61602-1274
Mailing Address - Country:US
Mailing Address - Phone:309-674-6633
Mailing Address - Fax:309-674-6694
Practice Address - Street 1:456 FULTON ST
Practice Address - Street 2:SUITE 140
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-1274
Practice Address - Country:US
Practice Address - Phone:309-674-6633
Practice Address - Fax:309-674-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007514152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046007514Medicaid
IL918460Medicare Oscar/Certification
IL1098100001Medicare NSC
ILT3884Medicare UPIN