Yaklich Optometry Inc – Optometrist in Morrison, IL

Key facts

NPI: 1609211523
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
License: 046010496 (IL)
Legal business name: YAKLICH OPTOMETRY INC
Practice address: 626 E Lincolnway
Suite B
Morrison, IL 61270-2966
Phone: (815) 772-7455
Fax: (815) 772-7457
NPI assigned: May 6, 2013
Organization subpart: No

Authorized official

Name: Dr. Bradley R Yaklich, O.D. NPI 1356629471
Title: President
Phone: (815) 772-7455

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

Practitioners 1

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

Bradley R Yaklich, O.D. Optometrist · Morrison, IL · NPI 1356629471

Medicare reassignment NPD Authorized official IL · OPTOMETRIST

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Yaklich Optometry Inc 626 E Lincolnway, Morrison, IL 61270-2900 · (815) 772-7455	Prosthetic Lenses: Conventional Eyeglasses\|Prosthetic Lenses: Conventional Contact Lenses	Accepts assignment Participating since Aug 19, 2013

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in IL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20131106001151	IL	Part B Supplier - Clinic/Group Practice	3375778996	Receives reassigned benefits from 1 practitioner Practice locations: Morrison, IL
O20140114000595	IL	DME Supplier - Physician - Optometrist	3375778996	Practice locations: Morrison, IL

National Provider Directory

Locations

201 E Market St
Morrison, IL 61270
Phone (815) 718-0020

626 E Lincolnway
Ste B
Morrison, IL 61270
Phone (815) 772-7455

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X SINGLE SPECIALTY GROUP	152W00000X	046010496	IL	Yes

Addresses

Primary practice location

626 E Lincolnway
Suite B
Morrison, IL 61270-2966

Mailing address

626 E Lincolnway
Suite B
Morrison, IL 61270-2966
Phone (815) 772-7455

Other providers in Morrison, IL

Whiteside County Community Health Clinic
Whiteside County Court Services
Ronald O Williams, D.C.
Matthew John Wolf, M.D.
Mark S Woods, M.D.
Bradley R Yaklich, O.D.
David A Yeager, DPM
Kendra Zuidema

All providers in Morrison, 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 Jan 10, 2014. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.