PAUL C JACOBS TREVOR CRABTREE PTR (NPI# 1649475328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649475328 |
| Entity Type | Organization |
| Organization Name | PAUL C JACOBS TREVOR CRABTREE PTR |
| Other Organization Name | JACOBS & CRABTREE DCTRS OF OPTOMETRY |
| Practice Address |
223 N Park Ave Herrin IL 62948-3149 |
| Mailing Address |
1508 Sioux Dr Marion IL 62959-5200 |
| Practice Telephone | 6189426887 |
| Practice Fax Number | 6189881209 |
| Mailing Telephone | 6189938787 |
| Mailing Fax Number | 6189976547 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2014-12-17 |
| Authorized Official Name | CAROLYN SUE KELLER (OFFICE MANAGER) |
| Authorized Official Telephone | 6189938787 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
046-008310 | IL | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| JACOBS & CRABTREE DCTRS OF OPTOMETRY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609072263 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1508 Sioux Dr, Marion, IL 62959-5209 | 2007-06-21 |
| 1619172368 | Paul C Jacobs Trevor Crabtree Ptr | Eyewear Supplier (Equipment, not the service) | 316 S Main St, Anna, IL 62906-1242 | 2007-06-20 |
| 1558352641 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1001 N Beadle Dr, Ste 40, Carbondale, IL 62901-1018 | 2005-10-29 |
| Street Address |
223 N PARK AVE |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
| 1225697675 | Park Ridge Vision LLC | Optometrist | 350 S Northwest Hwy Ste 104, Park Ridge, IL 60068-4262 | 2019-06-10 |
| 1679131213 | Union Eyes, LLC | Optometrist | 15900 W 127th St Ste 221, Lemont, IL 60439-2914 | 2019-05-29 |
| 1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
| 1588063572 | Northwestern Medical Faculty Foundation | Optometrist | 259 E. Erie Street, Suite#02-220, Chicago, IL 60611-2661 | 2014-08-15 |
| 1962734129 | Boyce Family Eye Care, Ltd. | Optometrist | 528 Devon Ave, Park Ridge, IL 60068-4820 | 2010-02-12 |
| 1558546713 | Halsted Eye Boutique, Inc. | Optometrist | 2852 N Halsted St, Chicago, IL 60657-6531 | 2008-01-07 |
| 1114119609 | Kapoor Vision Consultants, Ltd | Optometrist | 1221 W Talon Ct, Palatine, IL 60067-1848 | 2007-08-17 |
| 1356559595 | Concept Eye Care, Ltd. | Optometrist | 1605 E 55th St, 1st Flr, Chicago, IL 60615-5803 | 2007-05-20 |
| 1295943454 | Susanna C. Fostiak | Optometrist | 1724 Sherman Ave, Evanston, IL 60201-5607 | 2007-05-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PAUL C JACOBS TREVOR CRABTREE PTR.
| 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.