NPIMap

Organization Active NPI

Wyman Sicher Eye Associates SC

Doing business as Illinois Eye Center

  • Eyewear Supplier
  • Pekin, IL
National Provider Identifier
1114537123
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WYMAN SICHER EYE ASSOCIATES SC
Doing business as
Illinois Eye Center
Practice address
2709 Broadway St
Pekin, IL 61554-2676
Phone
(309) 243-2400
Fax
(309) 243-7918
NPI assigned
Aug 4, 2020
Last updated
Aug 4, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WYMAN SICHER EYE ASSOCIATES SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Authorized official

Name
John P Rhode, MDNPI 1235126897
Title
Physician Managing Partner
Phone
(309) 243-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2709 Broadway St
Pekin, IL 61554-2676

Mailing address

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-3869

Other names 1

  • Illinois Eye Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201021001955 IL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 7911965801 Practice locations: Pekin, IL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Wyman Sicher Eye Associates SC2709 Broadway St, Pekin, IL 61554-2676(309) 243-2400 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Wyman Sicher Eye Associates4 organizations share this tax ID, including this one
Part of
Wyman Sicher Eye Associates

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1200 Hamilton Blvd
Peoria, IL 61606
Phone (309) 671-8040

Interoperability endpoints

  • Direct secure messaging: direct@illinoiseyecenterpeoriail.compulinkdirect.com

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1114537123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3869",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 BROADWAY ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615542676",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYMAN SICHER EYE ASSOCIATES SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WYMAN SICHER EYE ASSOCIATES SC",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "RHODE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN MANAGING PARTNER",
        "authorized_official_telephone_number": "309-243-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@IllinoisEyeCenterPeoriaIL.CompulinkDirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2709 Broadway St",
            "city": "Pekin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615542676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Illinois Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.