Illinois Express Vis Ctr Dnvll Inc – Optometrist

Key facts

NPI: 1487724910
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
License: 046-007720 (IL)
Legal business name: ILLINOIS EXPRESS VIS CTR DNVLL INC
Practice address: 2807 N Vermilion St
Ste 4
Danville, IL 61832-1444
Phone: (217) 446-5554
NPI assigned: Nov 9, 2006
Organization subpart: No

Authorized official

Name: Mr. Mark Paris
Title: President
Phone: (217) 446-5554

Practitioners 2

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

Danny Robert Grider, O.D. Optometrist · Danville, IL · NPI 1407904790

NPD (past) OPTOMETRIST
Berry Allen Harris, OD Optometrist · Danville, IL · NPI 1437200516

NPD (past) OPTOMETRIST

National Provider Directory

Locations

2807 N Vermilion St
Ste 4
Danville, IL 61832
Phone (217) 446-5554

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X SINGLE SPECIALTY GROUP	152W00000X	046-007720	IL	Yes

Addresses

Primary practice location

2807 N Vermilion St
Ste 4
Danville, IL 61832-1444

Mailing address

2807 N Vermilion St
Ste 4
Danville, IL 61832-1444

Other names

Illinois Express Eyecare Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 16, 2012.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1487724910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 N VERMILION ST",
            "address_2": "STE 4",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 N VERMILION ST",
            "address_2": "STE 4",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321444",
            "telephone_number": "217-446-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS EXPRESS VIS CTR DNVLL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "PARIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-446-5554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Express Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, IL

All providers in Danville, IL · Optometrist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.