NPIMap

Organization Active NPI

Wyman Sicher Eye Associates SC

Doing business as Illinois Eye Center SC

  • Ophthalmology Physician
  • Peoria, IL
National Provider Identifier
1679593123
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WYMAN SICHER EYE ASSOCIATES SC
Doing business as
Illinois Eye Center SC
Practice address
8921 N. Wood Sage Rd
Peoria, IL 61615
Phone
(309) 243-2400
Fax
(309) 243-7918
NPI assigned
Jul 20, 2006
Last updated
Jul 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Dr. John P Rhode, M.D.NPI 1235126897
Title
Managing Partner
Phone
(309) 243-3869

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

8921 N. Wood Sage Rd
Peoria, IL 61615

Mailing address

8921 N. Wood Sage Rd
Peoria, IL 61615
Phone (309) 243-2400

Other identifiers 1

IdentifierTypeStateIssuer
07220057OtherILBLUE CROSS

Other names 1

  • Illinois Eye Center SC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041223000004 IL Part B Supplier - Clinic/Group Practice 7911965801 Receives reassigned benefits from 27 practitioners
Practice locations: Peoria, IL; Washington, IL; Pekin, IL; Kewanee, IL

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Wyman Sicher Eye Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2709 Broadway St
Pekin, IL 61554
Phone (309) 243-2400

8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000

8921 N Wood Sage Rd
#R
Peoria, IL 61615

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1679593123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N. WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 N. WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYMAN SICHER EYE ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "RHODE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "309-243-3869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07220057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Eye Center SC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Illinois Eye Center SC",
            "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 Jul 24, 2019; 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.