NPIMap

Organization Active NPI

Southern Illinois Eye Care PLLC

Doing business as Pinckneyville Eyecare

  • Optometrist
  • Pinckneyville, IL
National Provider Identifier
1053466045
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006727 Issued in IL
Legal business name
SOUTHERN ILLINOIS EYE CARE PLLC
Doing business as
Pinckneyville Eyecare
Practice address
15 N Locust St
Pinckneyville, IL 62274-1147
Phone
(618) 357-6117
NPI assigned
Jan 23, 2007
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN ILLINOIS EYECARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lawrence Gordon Soellner, ODNPI 1073595005
Title
Manager
Phone
(618) 826-4521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046006727 IL Primary

Addresses

Primary practice location

15 N Locust St
Pinckneyville, IL 62274-1147

Mailing address

15 N Locust St
Pinckneyville, IL 62274-1147
Phone (618) 357-6117

Other names 1

  • Pinckneyville Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050105000352 IL Part B Supplier - Clinic/Group Practice 8729036983 Receives reassigned benefits from 4 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pinckneyville, IL; Sparta, IL; Du Quoin, IL; Chester, IL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Duquoin Eyecare

Locations

630 S Washington St
Du Quoin, IL 62832
Phone (618) 542-6677

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1053466045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N LOCUST ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741147",
            "telephone_number": "618-357-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N LOCUST ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741147",
            "telephone_number": "618-357-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS EYE CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN ILLINOIS EYECARE, PC",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "SOELLNER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "618-826-4521",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinckneyville Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinckneyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.