NPIMap

Organization Active NPI

J a K Enterprises Inc

Doing business as Bard Optical

  • Eyewear Supplier
  • Peoria, IL
National Provider Identifier
1508856923
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
J A K ENTERPRISES INC
Doing business as
Bard Optical
Practice address
8309 N Knoxville Ave
Peoria, IL 61615-2170
Phone
(309) 693-9540
NPI assigned
Oct 26, 2005
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Ms. Diana J Hall
Title
President/Owner
Phone
(309) 693-9540

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

8309 N Knoxville Ave
Peoria, IL 61615-2170

Mailing address

8309 N Knoxville Ave
Peoria, IL 61615-2170
Phone (309) 693-9540

Other identifiers 2

IdentifierTypeStateIssuer
1508856923MedicaidIL
7215175OtherILBCBS

Other names 1

  • BARD OPTICAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040424000025 IL Part B Supplier - Clinic/Group Practice 3173519014 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Lincoln, IL; Washington, IL; Sterling, IL; Springfield, IL; Rock Island, IL; Pontiac, IL; Peru, IL; Peoria, IL…
O20241120002319 IL DME Supplier - Physician - Optometrist 3173519014 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Quincy, IL

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

331 W 1st Dr
Decatur, IL 62521
Phone (217) 422-3881

1477 Woodlawn Rd
Lincoln, IL 62656
Phone (217) 735-1707

3287 Court St
Pekin, IL 61554
Phone (309) 353-9313

4620 N University St
Peoria, IL 61614
Phone (309) 692-8222

3055 Wabash Ave
Springfield, IL 62704
Phone (217) 793-2273

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1508856923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J A K ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "309-693-9540",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508856923",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7215175",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARD OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BARD OPTICAL",
            "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 Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.