Illinois Eye, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

ILLINOIS EYE, LLC

Practice address

1630 Gateway Dr
Sycamore, IL 60178-3182

Phone

(815) 756-8571

Fax

(815) 756-5603

NPI assigned

Jul 27, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Michael T. Fricke

Title

Secretary

Phone

(844) 377-6468

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501113600000",
    "number": "1972027472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 N HARWOOD ST STE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012410",
            "telephone_number": "844-377-6468",
            "fax_number": "469-677-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783182",
            "telephone_number": "815-756-8571",
            "fax_number": "815-756-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS EYE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A",
        "authorized_official_last_name": "FRICKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "844-377-6468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Noelle Hughes
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• Bridget Irioogbe, LCPC
• Sibel Islamoglu
• Tifarah Jackson, LPC
• Edward Jacobs, ATC
• Rajeev Kumar Jain, M.D.

• Ophthalmology Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.