International Eyecare Center, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

INTERNATIONAL EYECARE CENTER, INC

Practice address

1233 W Morton Ave Ste C
Jacksonville, IL 62650-2774

Phone

(217) 245-8800

Fax

(217) 245-6100

NPI assigned

Feb 1, 2008

Last updated

Jan 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cathy Lee Short

Title

Credentialing Manager

Phone

(618) 462-9818

Specialties & licenses 2

Addresses

Other names 1

• Intl Eyrcr Ctr Inc Other name

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1982882981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 W MORTON AVE STE C",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502774",
            "telephone_number": "217-245-8800",
            "fax_number": "217-245-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL EYECARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "046009076",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intl Eyrcr Ctr Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Intl Eyrcr Ctr Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Jacksonville, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.