Eyecare Associates, LLP

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

046007251 Issued in IL

Legal business name

EYECARE ASSOCIATES, LLP

Practice address

2103 E Washington St Ste 1D
Bloomington, IL 61701-4365

Phone

(309) 662-2277

NPI assigned

Oct 9, 2007

Organization subpart

No

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

Authorized official

Name

John F Couillard, OD

Title

Partner

Phone

(309) 662-2277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eyecare Associates Former legal business name

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1881882504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 E. WASHINGTON",
            "address_2": "SUITE 1D",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014358",
            "telephone_number": "309-662-2277",
            "fax_number": "309-663-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 E WASHINGTON ST STE 1D",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014365",
            "telephone_number": "309-662-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "COUILLARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "309-662-2277",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "046007251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007251",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Eyewear Supplier in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.