Illiana Eyecare Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009654 Issued in IN

Legal business name

ILLIANA EYECARE INC

Practice address

13115 Wicker Avenue
Suite E
Cedar Lake, IN 46303

Phone

(219) 374-7800

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jill S Davids, O.D.NPI 1023078961

Title

Optometrist

Phone

(219) 669-1012

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 5

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

• Jill Suzanne Davids, O.D.

  • Optometrist
  • Crete, IL
  • NPI 1023078961

  IN

  Medicare reassignment Care Compare group NPD Authorized official
• Brittany Rae Disterheft, OD

  • Optometrist
  • Cedar Lake, IN
  • NPI 1760906135
  Medicare reassignment Care Compare group NPD
• Melissa Dawn Bourland, OD

  • Optometrist
  • Dyer, IN
  • NPI 1346766060
  Medicare reassignment NPD
• Kaitlyn Renae Gibson, OD

  • Optometrist
  • Cedar Lake, IN
  • NPI 1992319719
  Medicare reassignment NPD
• Paul A Veld, O.D.

  • Optometrist
  • Crete, IL
  • NPI 1225093883
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1215040142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13115 WICKER AVENUE",
            "address_2": "SUITE E",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "46303",
            "telephone_number": "219-374-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 WICKER AVENUE",
            "address_2": "SUITE E",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "46303",
            "telephone_number": "219-374-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLIANA EYECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "DAVIDS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "219-669-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "046009654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracee Harris
• Darlene Hayes, MS
• Isvi Hernandez, COTA
• Hook-Superx LLC
• Kristin Ann Huseman, DSW LCSW
• Sami Ismail, DO
• Kelly Jackson
• Abby Marie James, SLP
• Jon D. Misch, D.O.,P.C.
• Julie Berg Speech Pathology, P.C.

• Optometrist in Cedar Lake, IN
• Providers in Cedar Lake, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.