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ILLINOIS EYE SPECIALISTS NPI 1710105101


NPI Information

NPI: 1710105101
Provider Name: ILLINOIS EYE SPECIALISTS
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
2421 CORPORATE CTR STE 102
GRANITE CITY, IL
ZIP 62040
Phone: (618) 931-6980
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ILLINOIS EYE SPECIALISTS is an ophthalmology in Granite City, IL. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. ILLINOIS EYE SPECIALISTS NPI is 1710105101. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2421 CORPORATE CTR STE 102
GRANITE CITY, IL
ZIP 62040-195
Phone: (618) 931-6980
Fax: (618) 931-2470

The provider's authorized official is Edward A Doisy .
The authorized official title is President and has the following contact phone number (618) 931-6980.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 5/2/2012.


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
1207W00000XOphthalmology336017108ILLINOISYes

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
1C44292MEDICARE UPIN

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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