Mark D Esarey

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MARK D ESAREY

Practice address

1700 18TH Street
Charleston, IL 61920

Phone

(217) 345-6600

Fax

(217) 345-6622

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark D Esarey, OD

Title

Owner

Phone

(217) 345-6600

Specialties & licenses 1

Addresses

Other identifiers 8

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1790867604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 18TH STREET",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-345-6600",
            "fax_number": "217-345-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 18TH STREET",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-345-6600",
            "fax_number": "217-345-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D ESAREY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "ESAREY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-345-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV ID#",
            "identifier": "1584009",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "1790867604",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE",
            "identifier": "1790867604",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF5536",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548267099",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFLAC",
            "identifier": "1790867604",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1790867604",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSF HEALTHCARE",
            "identifier": "1790867604",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah L Malak, LCSW
• Amy L Malmen, RPH
• Bernadette Mangialardi, LCPC
• Janette S Marciano, PA-C
• Maria Horvat MD SC
• Nancy Ann Martin
• Scott Dean Martin, D.D.S.
• Chuck L Mason, BS
• Zachary Steven Mayberry
• Marilyn McBride

• Optometrist in Charleston, IL
• Providers in Charleston, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.