DR. MARK VIDAS (NPI# 1881787901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881787901 |
| Entity Type | Individual |
| Full Name | DR. MARK VIDAS |
| Credential | O.D. |
| Practice Address |
135 W River St Bourbonnais IL 60914-1964 |
| Mailing Address |
101 Terrace Ct Bourbonnais IL 60914-0806 |
| Practice Telephone | 8159392222 |
| Practice Fax Number | 8159390970 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
046007828 | IL | Eye and Vision Services Providers |
| Street Address |
135 W RIVER ST |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-1964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245566363 | Erik Ranta | Optometrist | 135 W River St, Bourbonnais, IL 60914-1964 | 2009-10-23 |
| 1285751552 | Meyer Optical Co. Inc. | Optometrist | 135 W River St, Bourbonnais, IL 60914-1964 | 2007-03-23 |
| 1538204995 | Shawn W. Danahey | Optometrist | 135 W River St, Bourbonnais, IL 60914-1964 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| 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 |
| 1649475328 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 223 N Park Ave, Herrin, IL 62948-3149 | 2007-06-20 |
| 1356559595 | Concept Eye Care, Ltd. | Optometrist | 1605 E 55th St, 1st Flr, Chicago, IL 60615-5803 | 2007-05-20 |
| Find all providers with the same taxonomy | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
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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.