NPIMap

Organization Active NPI

Wyman Sicher Eye Associates SC

Doing business as Illinois Eye Center SC

  • Eyewear Supplier
  • Peoria, IL
National Provider Identifier
1285779546
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WYMAN SICHER EYE ASSOCIATES SC
Doing business as
Illinois Eye Center SC
Practice address
8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone
(309) 243-2400
Fax
(309) 243-7918
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Authorized official

Name
Dr. Thomas M Wyman, M.D.NPI 1245227669
Title
President
Phone
(309) 243-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

8921 N Wood Sage Rd
Peoria, IL 61615-7822

Mailing address

8921 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-2400

Other identifiers 1

IdentifierTypeStateIssuer
07220057OtherBLUE CROSS

Other names 1

  • Illinois Eye Center SC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930005410 IL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 7911965801 Practice locations: Peoria, IL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Wyman Sicher Eye Associates SC8921 N Wood Sage Rd, Peoria, IL 61615-7822(309) 243-2400 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Illinois Eye Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1285779546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYMAN SICHER EYE ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "WYMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-243-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07220057",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Eye Center SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.