Mt Vernon Eyecare

LBN: Illinois Express Vision Center, Mattoon Inc
Mt Vernon Eyecare is an health care organization with primary practice located at 3917 Broadway St Times Square Mall, Mount Vernon IL 62864-2290. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Illinois Express Vision Center, Mattoon Inc can be contacted via phone (618) 244-5522, or through Miller, Amy Marie via phone (217) 235-1100.

Contact Information

Primary practice address
3917 Broadway St Times Square Mall Mount Vernon IL 62864-2290
Phone: (618) 244-5522
Fax: (618) 244-9512
Website:
Map and Directions
Authorized official contact:
Name: Miller, Amy Marie
Phone: (217) 235-1100

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1679742183
LBN Legal business name Illinois Express Vision Center, Mattoon Inc
DBA Doing business as Mt Vernon Eyecare
Authorized official Miller, Amy Marie
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2008
Last updated Mar 23rd, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679742183 NPPES
Illinois MEDICAID 371279746001

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