GAILEY EYE SURGERY - DECATUR, LLC (NPI# 1023056090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023056090 |
| Entity Type | Organization |
| Organization Name | GAILEY EYE SURGERY - DECATUR, LLC |
| Practice Address |
646 W Pershing Rd Decatur IL 62526-1633 |
| Practice Telephone | 2178752600 |
| Practice Fax Number | 2178759525 |
| Mailing Telephone | 2178752600 |
| Mailing Fax Number | 2178759525 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2016-03-14 |
| Authorized Official Name | DR. ROBERT M LEE (PRESIDENT, GAILEY EYE CLINIC) |
| Authorized Official Telephone | 3098295311 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0132X |
Clinic/Center Specialization: Ophthalmologic Surgery |
IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHEILD | 50636 | 01 |
| Street Address |
646 W PERSHING RD |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-1633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932200094 | Macon County Eye Center PC | Ophthalmology | 646 W Pershing Rd, Decatur, IL 62526-1633 | 2006-09-25 |
| 1538260609 | Sushant K Sinha | Ophthalmology | 646 W Pershing Rd, Decatur, IL 62526-1633 | 2006-09-25 |
| 1902907082 | Christine L Warchol | Ophthalmology | 646 W Pershing Rd, Decatur, IL 62526-1633 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 261QS0132X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ophthalmologic Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477036671 | Chicago Lasik Center, LLC | Clinic/Center | 405 N Wabash Ave Ste P-2e, Chicago, IL 60611-3591 | 2018-09-13 |
| 1811479058 | Essential Ophthalmology Inc | Clinic/Center | 4646 N Marine Dr Ste A5400, Chicago, IL 60640-5759 | 2018-09-04 |
| 1750765012 | Illinois Retina Associates, S.c. | Clinic/Center | 71 W 156th St Ste 400, Harvey, IL 60426-4265 | 2015-07-16 |
| 1427698489 | Deseye Retina LLC | Clinic/Center | 15905 S Frederick St Ste 105, Plainfield, IL 60586-2212 | 2020-01-07 |
| 1932742541 | Aghapy LLC | Clinic/Center | 5683 N Milwaukee Ave, Chicago, IL 60646-6220 | 2019-10-26 |
| 1003340415 | Km Williams Md Sc | Clinic/Center | 1725 W Harrison St, Ste 910, Chicago, IL 60612-3841 | 2017-04-12 |
| 1356897748 | The Cataract Vision Institute LLC | Clinic/Center | 1 Mid America Plz, Suite 250, Oakbrook Terrace, IL 60181-4450 | 2016-08-26 |
| 1255564258 | Lake Shore Retina, S. C. | Clinic/Center | 850 W Irving Park Rd, Chicago, IL 60613-3077 | 2009-08-25 |
| 1184896219 | Nierman Nierman & Nierman | Clinic/Center | 151 Mchenry Rd, Buffalo Grove, IL 60089-1796 | 2008-03-28 |
| 1790983914 | Elmhurst Eye Surgery Center | Clinic/Center | 152 N Addison Ave, Elmhurst, IL 60126-2821 | 2007-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.