Mark D. Wade O D P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

MO2999 Issued in MO

Legal business name

MARK D. WADE O D P C

Practice address

111 E 4TH St Ste 440
Alton, IL 62002-6206

Phone

(618) 462-9818

Fax

(314) 741-4947

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Mark D. Wade, OD

Title

President

Phone

(618) 462-9818

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1275981698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D. WADE O D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-462-9818",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "MO2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megha Bharat Manek, MD
• Drew Henry Maness, RN
• Angela Mangi
• Mario J Marcinczyk, MD
• John Michael Marincel, D.D.S.
• Shelby Ann Markel, MD
• Stacy R Marriott, APRN, CNP
• Dena Marshall, PT
• Brianna Martin
• Clifford Glenn Martin, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.