Patricia Helen Simpson, O. D.
Individual provider Active NPI Optometrist · Coal City, IL
NPI 1649274366 · NPPES record last updated Apr 13, 2021
Key facts
- NPI
- 1649274366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046007569 (IL)
- Practice address
- 20 E North St
Coal City, IL 60416-1087 - Phone
- (815) 634-4825
- Fax
- (815) 634-4938
- NPI assigned
- Jun 10, 2005
- Reactivated
- Mar 20, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046007569 | IL | Yes |
Addresses
Primary practice location
20 E North St
Coal City, IL 60416-1087
Mailing address
1950 Old Gallows Rd # Suie520
Vienna, VA 22182-3990
Phone (703) 847-8899
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046007569 | Medicaid | IL | |
| 09932280 | Other | IL | BCBS OF IL |
Other providers in Coal City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2021. 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.