Organization Active NPI

Midwest Eye Care PC

  • Durable Medical Equipment & Medical Supplies
  • Pekin, IL
National Provider Identifier
1780786160
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MIDWEST EYE CARE PC
Practice address
101 N Parkway Dr
Pekin, IL 61554-3932
Phone
(309) 347-5115
Fax
(309) 347-7036
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Traci Bacon
Title
Office Manager
Phone
(309) 347-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X IL Primary

Addresses

Primary practice location

101 N Parkway Dr
Pekin, IL 61554-3932

Mailing address

101 N Parkway Dr
Pekin, IL 61554-3932
Phone (309) 347-5115

National Provider Directory

National Provider Directory

Locations

4727 N Sheridan Rd
Peoria, IL 61614
Phone (309) 688-1345

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780786160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N PARKWAY DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543932",
            "telephone_number": "309-347-5115",
            "fax_number": "309-347-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N PARKWAY DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543932",
            "telephone_number": "309-347-5115",
            "fax_number": "309-347-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-347-5115"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.