Absolute Vision Care III, Inc.
Organization Active NPI Optometrist · Manhattan, IL
NPI 1891922100 · NPPES record last updated Mar 18, 2014
Key facts
- NPI
- 1891922100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ABSOLUTE VISION CARE III, INC.
- Practice address
- 300 Market PL
Manhattan, IL 60442-8100 - Phone
- (708) 371-5162
- Fax
- (708) 930-1844
- NPI assigned
- Jun 12, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Rick E Peterson, OD
- Title
- Owner
- Phone
- (708) 371-5162
Practitioners 5
-
Alex Lopez, OD
-
Rick E Peterson, O.D.
-
Taryn Lee Majewski, O.D.
-
James B Sowinski, O.D.
-
Brian Oswald, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090909000173 | IL | Part B Supplier - Clinic/Group Practice | 6305991795 |
Receives reassigned benefits from 4 practitioners Practice locations: Manhattan, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
300 Market PL
Manhattan, IL 60442-8100
Mailing address
300 Market PL
Manhattan, IL 60442-8100
Phone (708) 371-5162
Other providers in Manhattan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.