Active NPI
Southern Illinois Eyecare PLLC
- Optometrist
- Sparta, IL
National Provider Identifier
1144375866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 047931268
- Legal business name
- SOUTHERN ILLINOIS EYECARE PLLC
- Practice address
- 520 E Broadway St
Sparta, IL 62286-1889 - Phone
- (618) 443-5252
- NPI assigned
- Jan 24, 2007
- Organization subpart
- Yes
- Parent organization
- SOUTHERN ILLINOIS EYECARE, PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Pouyat
- Title
- President
- Phone
- (847) 395-8885
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 047931268 | IL | Primary |
Addresses
Primary practice location
520 E Broadway St
Sparta, IL 62286-1889
Mailing address
520 E Broadway St
Sparta, IL 62286-1889
Phone (618) 443-5252
Other names 2
- Southern Illinois Eye Care
- Sparta Eyecare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Southern Illinois Eyecare P
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780012800000",
"number": "1144375866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 E BROADWAY ST",
"city": "SPARTA",
"state": "IL",
"postal_code": "622861889",
"telephone_number": "618-443-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E BROADWAY ST",
"city": "SPARTA",
"state": "IL",
"postal_code": "622861889",
"telephone_number": "618-443-5252"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN ILLINOIS EYECARE PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHERN ILLINOIS EYECARE, PC",
"enumeration_date": "2007-01-24",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A",
"authorized_official_last_name": "POUYAT",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "847-395-8885"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "IL",
"license": "047931268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southern Illinois Eye Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sparta Eyecare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sparta, IL
- Jeffery Michael Sauzek, PHARM.D.
- Leslie Jean Sauzek, PHARM.D.
- Rikki Schaefer, PA
- Scott David Schneid, O.D.
- Danielle Scott, PA-C
- Southern Illinois Spine & Joint Center, LLC
- Sparta Community Hospital
- Sparta Community Hospital
- Sparta Community Hospital
- Sparta Community Hospital D/B/a Quality Healthcare Clinics
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.