ILLINOIS EXPRESS VISION CENTER, MATTOON INC (NPI# 1679742183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679742183 |
Entity Type | Organization |
Organization Name | ILLINOIS EXPRESS VISION CENTER, MATTOON INC |
Other Organization Name | MT VERNON EYECARE |
Practice Address |
3917 Broadway St Times Square Mall Mount Vernon IL 62864-2290 |
Mailing Address |
420 Broadway Ave E Mattoon IL 61938-4604 |
Practice Telephone | 6182445522 |
Practice Fax Number | 6182449512 |
Mailing Telephone | 2172351100 |
Mailing Fax Number | 2172351126 |
Enumeration Date | 2008-02-28 |
Last Update Date | 2016-03-23 |
Authorized Official Name | AMY MARIE MILLER (ASSISTANT MANAGER) |
Authorized Official Telephone | 2172351100 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 371279746001 | 05 |
Other Name | Type Code |
---|---|
MT VERNON EYECARE | Doing Business As Name - Organization |
Street Address |
3917 BROADWAY ST TIMES SQUARE MALL |
City | MOUNT VERNON |
State | IL |
Zip Code | 62864-2290 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306077995 | Douglas Heaton | Hearing Instrument Specialist | 3917 Broadway St, Mount Vernon, IL 62864-2205 | 2009-07-31 |
1699824235 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 3917 Broadway St, Times Square Mall, Mount Vernon, IL 62864-2205 | 2007-01-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
Find all providers in zip 62864 |
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 |
---|---|---|---|---|
1417236803 | Amanda Montgomery | Optometrist | 812 Coshocton Ave # 3, Mount Vernon, OH 43050-1947 | 2011-08-16 |
1982898375 | Clarkson Optometry Illinois PC | Optometrist | 3000 Broadway St, Mount Vernon, IL 62864-2340 | 2007-08-29 |
1679629521 | James Laurence Edick | Optometrist | 5 W High St, Mount Vernon, OH 43050-3282 | 2007-01-25 |
1518014737 | Neil Scott Eberhardt | Optometrist | 1427 N Laventure Rd, Mount Vernon, WA 98273-2765 | 2007-01-03 |
1538223417 | David W Wineland | Optometrist | 110 Coshocton Ave, Mount Vernon, OH 43050-2628 | 2006-12-21 |
1235200429 | Tod W Jones | Optometrist | 1616 N 18th St Ste 104, Mount Vernon, WA 98273-2600 | 2006-11-11 |
1609957885 | Mount Vernon Eyecare Associates, LLC | Optometrist | 104 S Hickory, Mount Vernon, MO 65712 | 2006-10-17 |
1043304710 | Percav, Inc | Optometrist | 112 S 42nd Street, Mount Vernon, IL 62864 | 2006-10-03 |
1538278445 | Terry G. Cook | Optometrist | 4200 Ilberry Rd, Mount Vernon, IL 62864-6748 | 2006-08-30 |
1245348473 | Richard Wayne York | Optometrist | 1684 Venture Dr, Suite A, Mount Vernon, OH 43050-8950 | 2006-08-28 |
Find all providers in MOUNT VERNON |
City | MOUNT VERNON |
Zip Code | 62864 |
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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.