Illinois Physicians Eyecare Group, S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ILLINOIS PHYSICIANS EYECARE GROUP, S.C.

Practice address

2415 W Glen Ave
Peoria, IL 61614-4533

Phone

(309) 966-1236

Fax

(309) 693-2131

NPI assigned

Nov 30, 2018

Organization subpart

No

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

Authorized official

Name

Alisha Jackson

Title

Senior Revenue Manager

Phone

(561) 208-1591

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1669942884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24686",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874686",
            "telephone_number": "561-275-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 W GLEN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144533",
            "telephone_number": "309-966-1236",
            "fax_number": "309-693-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS PHYSICIANS EYECARE GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-30",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "SENIOR REVENUE MANAGER",
        "authorized_official_telephone_number": "561-208-1591"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Peoria, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.