NPIMap

Organization Active NPI

Illini Eyecare Inc-Champaign

  • Optometrist
  • Champaign, IL
National Provider Identifier
1447420518
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009770 Issued in IL
Legal business name
ILLINI EYECARE INC-CHAMPAIGN
Practice address
518 E Green St
Champaign, IL 61820-5720
Phone
(217) 351-6110
Fax
(217) 351-6395
NPI assigned
Mar 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Kelly Alice Sanders, ODNPI 1619013117
Title
Optometrist
Phone
(217) 351-6110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046009770 IL Primary

Addresses

Primary practice location

518 E Green St
Champaign, IL 61820-5720

Mailing address

518 E Green St
Champaign, IL 61820-5720
Phone (217) 351-6110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1447420518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 E GREEN ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205720",
            "telephone_number": "217-351-6110",
            "fax_number": "217-351-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 E GREEN ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205720",
            "telephone_number": "217-351-6110",
            "fax_number": "217-351-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINI EYECARE INC-CHAMPAIGN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "217-351-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.