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VINTAGE OPTICAL BRIAN C SOMMER OD LTD. NPI 1073756490


NPI Information

NPI: 1073756490
Provider Name: VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD.
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 14D2096392

Address:
417 W JEFFERSON ST
MORTON, IL
ZIP 61550
Phone: (309) 263-8611
Get Directions

VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD. is an optometrist in Morton, IL. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. VINTAGE OPTICAL BRIAN C SOMMER, OD, LTD. NPI is 1073756490. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

417 W JEFFERSON ST
MORTON, IL
ZIP 61550-817
Phone: (309) 263-8611
Fax: (309) 263-8926

The provider's authorized official is Susan E Colby .
The authorized official title is Corp Secretary and has the following contact phone number (309) 263-8611.

The CLIA number assigned to this NPI record is 14D2096392 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/15/2009 and was last updated on 2/13/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist046.007309ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1410046605OTHERMEDICARE RAILROAD
2IL6829MEDICARE UPINILLINOIS
34429890001MEDICARE NSC
410760649OTHERCAQH PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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