DR. HARVEY MACK (NPI# 1386692630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386692630 |
| Entity Type | Individual |
| Full Name | DR. HARVEY MACK |
| Credential | OD |
| Practice Address |
2020 W Iles Ave Springfield IL 62704-4174 |
| Practice Telephone | 2176983030 |
| Practice Fax Number | 2176983068 |
| Mailing Telephone | 2176983030 |
| Mailing Fax Number | 2176983068 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | P00315313 | 01 |
| Street Address |
2020 W ILES AVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-4174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578568077 | Robert James Blumthal | Optometrist | 2020 W Iles Ave, Springfield, IL 62704-4174 | 2005-06-20 |
| 1467930735 | Kaylyn Marie Nickelson | Optometrist | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2018-07-30 |
| 1063862266 | Emily Beyer | Optometrist | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2016-06-18 |
| 1073975348 | Jason Allen Noble | Ophthalmology | 2020 W Iles Ave, Springfield, IL 62704-4174 | 2016-03-24 |
| 1003298803 | Monica Ryan | Optometrist | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2015-06-29 |
| 1548605843 | Fahad Habib Khan | Ophthalmology | 2020 W Iles Ave, Springfield, IL 62704 | 2013-05-01 |
| 1235440777 | Chelsey Moore | Optometrist | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2010-06-30 |
| 1508183427 | Mohamed G Gendy | Ophthalmology | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2010-05-02 |
| 1790979011 | William Wen-long Yang | Ophthalmology | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2007-08-29 |
| 1316147564 | Frederick M Rauscher | Ophthalmology | 2020 W Iles Ave, Springfield, IL 62704-7015 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| 1376180109 | Drs. Akre & Clark, Ltd. | Optometrist | 623 W Rock St, Springfield, MN 56087-1028 | 2019-11-27 |
| 1407410087 | Missouri Physicians Eyecare Group, P.C. | Optometrist | 1415 E Battlefield St, Springfield, MO 65804-3701 | 2019-04-29 |
| 1467931006 | Vision Care Focus, LLC | Optometrist | 1507 Mohawk Blvd, Springfield, OR 97477-3355 | 2018-08-13 |
| 1306337126 | Casey Marie Smith | Optometrist | 1024 N Plum St, Springfield, OH 45504-2108 | 2018-05-29 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1790299311 | Springfield Eye Specialists LLC | Optometrist | 3231 S National Ave Ste 165, Springfield, MO 65807-7304 | 2017-11-17 |
| 1093253247 | Minh-tam Nguyen | Optometrist | 8424 Old Keene Mill Rd, Springfield, VA 22152-2302 | 2017-02-08 |
| 1013453877 | Grace Chang, Od PC | Optometrist | 6575n Frontier Dr, Springfield, VA 22150-1415 | 2017-01-17 |
| 1669821914 | Laura Kay | Optometrist | 1342 E Primrose St Ste B, Springfield, MO 65804-4224 | 2016-06-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.