Nu-Crown, LLC
Organization Active NPI Optometrist · Alton, IL
NPI 1295737294 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1295737294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- NU-CROWN, LLC
- Practice address
- 111 E 4TH St Ste 440
Alton, IL 62002-6206 - Phone
- (618) 462-9818
- Fax
- (314) 741-4947
- NPI assigned
- Aug 10, 2005
- Organization subpart
- No
Authorized official
- Name
- Melissa Allison
- Title
- Sr. Director RCM/MVC
- Phone
- (618) 462-9818
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Practitioners 77
-
Christina J. Levi, O.D.
-
Jacqlyn E Long, O.D.
-
Chih Jen Wang, O.D.
-
Quinn Gallen, OD
-
Leslie Kinder, OD
-
Alexa S Kojima, O.D.
-
John J. Konopik, O.D.
-
Charles M. Lutz, O.D.
-
Julia Mobilio, OD
-
Theresa Osborne, OD
-
Kara C Rackovan, OD
-
Eneida Resuli, OD
-
Mohammed Salman, OD
-
Keyur Savla, OD
-
Mark D. Wade, O.D.
-
Matthew J. Woodyard, O.D.
-
Amy Schaag, O.D.
-
Natalie J. Hutchison, O.D.
-
Ayhubrhan Yifru, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040415000463 | IL | Part B Supplier - Clinic/Group Practice | 1456256346 |
Receives reassigned benefits from 7 practitioners Practice locations: Alton, IL; O Fallon, IL |
| O20041025000051 | MO | Part B Supplier - Clinic/Group Practice | 1456256346 |
Receives reassigned benefits from 43 practitioners 1 other NPI on this enrollment Practice locations: Saint Louis, MO; St Ann, MO; St Louis, MO; St Peters, MO; Saint Charles, MO; Creve Coeur, MO; Florissant, MO; Ballwin, MO… |
National Provider Directory
Locations
6575 N Illinois St
Fairview Heights, IL 62208
Phone (618) 397-6575
1560 W Highway 50
O Fallon, IL 62269
Phone (618) 397-6575
935 N Highway 67 St
Florissant, MO 63031
Phone (314) 838-7644
937 N Highway 67 St
Florissant, MO 63031
427 Lafayette Ctr
Manchester, MO 63011
Phone (636) 391-1309
1817 Maplewood Commons Dr
Maplewood, MO 63143
Phone (314) 296-5367
361 Winding Woods Ctr
Ste 8
O Fallon, MO 63366
Phone (636) 281-5367
1910 1st Capitol Dr
Saint Charles, MO 63301
Phone (314) 741-8183
1944 Zumbehl Rd
Saint Charles, MO 63303
Phone (636) 916-5367
1940 Zumbehl Rd
Saint Charles, MO 63303
Phone (636) 916-5367
3718 S Kingshighway Blvd
Saint Louis, MO 63109
Phone (314) 446-1134
3732 S Kingshighway Blvd
Saint Louis, MO 63109
Phone (314) 446-1134
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
111 E 4TH St Ste 440
Alton, IL 62002-6206
Mailing address
111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC7072 | Other | MO | RAILROAD MEDICARE |
| CK2084 | Other | IL | RAILROAD MEDICARE |
Other names
- Crown Optical
- Crown Vision Center
Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.