J.E. Tallis Dba American Vision Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007271 Issued in IL

Legal business name

J.E. TALLIS DBA AMERICAN VISION CENTER

Practice address

915 N Main St
Bloomington, IL 61701-3043

Phone

(309) 827-8434

Fax

(309) 828-6741

NPI assigned

Apr 30, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Chrisann Tallis

Title

Office Manager

Phone

(309) 827-8434

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay E Tallis, OD

  • Optometrist
  • Bloomington, IL
  • NPI 1083627830
  NPD (past)

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1164698148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N MAIN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013043",
            "telephone_number": "309-827-8434",
            "fax_number": "309-828-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N MAIN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013043",
            "telephone_number": "309-827-8434",
            "fax_number": "309-828-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.E. TALLIS DBA AMERICAN VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "TALLIS",
        "authorized_official_first_name": "CHRISANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-827-8434",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007271",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "934801",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ireland Grove Center for Surgery LLC.
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• George Stephen Irwin, M.D.
• Pamela Ann Ives
• J. Mitchell Counseling, PLLC
• Bethany Jackson
• Jessica Jackson, LPC
• Autumn Jacobs
• Daniel R Jacobsen, D.M.D.
• Cynthia Marie Jagodzinski

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.