Barbara Portillo (NPI# 1952454035, PAC ID# 1052375474) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1952454035 |
| PAC ID by PECOS | 1052375474 |
| Professional Enrollment ID | I20170330002378 |
| Full Name | Barbara Portillo |
| Organization Legal Name | JAK ENTERPRISES INC |
| Address |
8309 N Knoxville Ave Suite 1 Peoria IL 61615-2171 |
| Phone Number | 3097133664 |
| Gender | F |
| Credential | OD |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 1983 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 3173519014 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1700 Pkwy Plaza Dr, Normal, IL 61761-2896 | 3094542233 | JAK ENTERPRISES INC |
| 1700 Pkwy Plaza Dr, Suite 4, Normal, IL 61761-2896 | 3094542233 | JAK ENTERPRISES INC |
| 8309 N Knoxville Ave, Suite 1, Peoria, IL 61615-2171 | 3097133664 | JAK ENTERPRISES INC |
| 8309 N Knoxville Ave, Peoria, IL 61615-2171 | 3097133664 | JAK ENTERPRISES INC |
| Organization Legal Name | JAK ENTERPRISES INC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharna Annise Wiltz | Optometry | Jak Enterprises Inc | 3287 Court St, Pekin, IL 61554-6208 |
| Molly M Guithues | Optometry | Jak Enterprises Inc | 331 W 1st Dr, Decatur, IL 62521-5207 |
| Nicole M Jensen | Optometry | Jak Enterprises Inc | 1200 W Main St, Suite 21, Peoria, IL 61606-1218 |
| Rhonda Dameron | Optometry | Jak Enterprises Inc | 8309 N Knoxville Ave, Suite 1, Peoria, IL 61615-2171 |
| Steven H Lane | Optometry | Jak Enterprises Inc | 1351 Hickory Point Dr, B, Forsyth, IL 62535-1085 |
| Jeffrey S Heden | Optometry | Jak Enterprises Inc | 4032 46th Ave, Rock Island, IL 61201-7164 |
| Brian D Henson | Optometry | Jak Enterprises Inc | 1712 W Reynold Rd, Pontiac, IL 61764-9695 |
| John J Rimkus | Optometry | Jak Enterprises Inc | 3215 E Lincolnway, Sterling, IL 61081-1772 |
| Stacy A Twenhafel | Optometry | Jak Enterprises Inc | 907 W Marketview Dr, Champaign, IL 61822-1227 |
| David R Morgret | Optometry | Jak Enterprises Inc | 1265 N Henderson St, Galesburg, IL 61401-1510 |
| Street Address |
8309 N KNOXVILLE AVE SUITE 1 |
| City | PEORIA |
| State | IL |
| Zip | 61615-2171 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rhonda Dameron | Optometry | Jak Enterprises Inc | 8309 N Knoxville Ave, Suite 1, Peoria, IL 61615-2171 |
| Marc C Sarmiento | Optometry | Jak Enterprises Inc | 8309 N Knoxville Ave, Suite 1, Peoria, IL 61615-2171 |
| Rebecca D Ryan | Optometry | Jak Enterprises Inc | 8309 N Knoxville Ave, Peoria, IL 61615-2170 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer N Thompson | Ophthalmology | Gailey Eye Clinic, Ltd | 8800 N Orange Prairie, Peoria, IL 61615 |
| Jeffrey Y Liang | Internal Medicine | Iowa Physicians Clinic Medical Foundation | 10322 N Juliet Ct, Peoria, IL 61615-1199 |
| Matthew Carr | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Abby G Freckleton | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Susannah Dintzis | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Michael J Pace | Family Practice | Methodist Medical Center of Illinois | 8914 N Knoxville Ave, Peoria, IL 61615-1410 |
| Amanda Miriam Kilgore | Physical Therapy | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Michael Dominic Tarantino | Hematology/oncology | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | |
| Rohith Jesudas | Pediatric Medicine | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Elizabeth A Lepper | Nurse Practitioner | Michael D. Tarantino, M.d. S.c. | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 |
| Find all physicians in zip 61615 | |||
| City | PEORIA |
| Zip Code | 61615 |
| Specialty | OPTOMETRY |
| City + Specialty | PEORIA + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.