Midwest Vision Clinic PLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MIDWEST VISION CLINIC PLC

Practice address

1130 17TH Street
Fulton, IL 61252

Phone

(815) 589-2252

Fax

(815) 589-4201

NPI assigned

Jul 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian W Peck, ODNPI 1417982828

Title

Owner Optometrist

Phone

(815) 589-2552

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Brian W Peck, OD

  • Optometrist
  • Clinton, IA
  • NPI 1417982828
  NPD Authorized official

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154345551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 17TH STREET",
            "city": "FULTON",
            "state": "IL",
            "postal_code": "61252",
            "telephone_number": "815-589-2252",
            "fax_number": "815-589-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 17TH STREET",
            "city": "FULTON",
            "state": "IL",
            "postal_code": "61252",
            "telephone_number": "815-589-2252",
            "fax_number": "815-589-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST VISION CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "815-589-2552",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Journey Well Therapy and Coaching PLLC
• Tom M Kao, D.C., APN
• Scott Kunau, D.D.S.
• Medical Associates of Clinton, Iowa, P.L.C. (Fulton Family Health Clinic)
• Mercy Specialty Clinic (MercyOne Fulton Family Medicine)
• Kristin Marie Mortensen-Ward, CPM, LM CPM, LCPM
• Kimberly K Mulholland, ARNP
• Osteopractic Physical Therapy of the Midwest
• River Bend Cusd 2
• Emily Mae Santana

• Optometrist in Fulton, IL
• Providers in Fulton, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.