NPIMap

Organization Active NPI

Eyecare Management, LLC

Doing business as Illinois Eye Surgeons

  • Optometrist
  • Collinsville, IL
National Provider Identifier
1811224710
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006474 Issued in IL
Legal business name
EYECARE MANAGEMENT, LLC
Doing business as
Illinois Eye Surgeons
Practice address
415 W Main St
Collinsville, IL 62234-3043
Phone
(618) 345-7887
Fax
(618) 277-4917
NPI assigned
Nov 13, 2009
Last updated
May 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Misty L Pelaez
Title
PR
Phone
(618) 532-1082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046006474 IL Primary

Addresses

Primary practice location

415 W Main St
Collinsville, IL 62234-3043

Mailing address

3990 N Illinois St
Swansea, IL 62226-1919
Phone (618) 277-1130

Other names 1

  • Illinois Eye Surgeons Doing business as

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1811224710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261919",
            "telephone_number": "618-277-1130",
            "fax_number": "618-277-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W MAIN ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622343043",
            "telephone_number": "618-345-7887",
            "fax_number": "618-277-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "PELAEZ",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PR",
        "authorized_official_telephone_number": "618-532-1082"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois Eye Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.