Gailey Eye Clinic, LTD
Organization Active NPI Ophthalmic Technician/Technologist · Peru, IL
NPI 1487859401 · NPPES record last updated Apr 14, 2008
Key facts
- NPI
- 1487859401
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ophthalmic Technician/Technologist 156FX1100X
- Legal business name
- GAILEY EYE CLINIC, LTD
- Practice address
- 2121 Marquette Rd
Peru, IL 61354-1588 - Phone
- (815) 224-1100
- NPI assigned
- Jun 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Rebecca Cox
- Title
- Administrative Assistant
- Phone
- (309) 829-5311
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 4
Practitioners 3
-
Ara David Aprahamian, M.D.
-
Kenneth R Barba, M.D.
-
Julie B. Hendricks, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040802000570 | IL | Part B Supplier - Clinic/Group Practice | 2769469337 |
Receives reassigned benefits from 23 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Peoria, IL; Watseka, IL; Springfield, IL; Peru, IL; Pekin, IL; Ottawa, IL; Galesburg, IL; Forsyth, IL… |
National Provider Directory
- Tax ID family
- Gailey Eye Clinic LTD
Locations
2121 Marquette Rd
Peru, IL 61354
Phone (815) 224-1100
1401 S Koke Mill Rd
Springfield, IL 62711
Phone (217) 529-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist |
156FX1100X | IL | Yes |
Addresses
Primary practice location
2121 Marquette Rd
Peru, IL 61354-1588
Mailing address
2121 Marquette Rd
Peru, IL 61354-1588
Phone (815) 224-1100
Other providers in Peru, IL
- Kayla Marie Fallen
- Family Foot Care PC
- Brenden Fasken
- Mark Allen Fernandez
- Kassi Ann Filipiak
- Rakesh K Garg
- Christine Marie Garretson
- Girlfriends, LLC
- Neelam Goel
- Ram Goel
All providers in Peru, IL · Ophthalmic Technician/Technologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2008. 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.