JAK ENTERPRISES DBA JAK OPTICAL LABORATORIES (NPI# 1083158372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083158372 |
| Entity Type | Organization |
| Organization Name | JAK ENTERPRISES DBA JAK OPTICAL LABORATORIES |
| Other Organization Name | JAK OPTICAL LABORATORIES |
| Practice Address |
8309 N Knoxville Ave Peoria IL 61615-2170 |
| Mailing Address |
Po Box 3333 Peoria IL 61612-3333 |
| Practice Telephone | 8006542833 |
| Practice Fax Number | 8003221822 |
| Mailing Telephone | 3097131762 |
| Mailing Fax Number | 3099660922 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | DIANA J HALL (PRESIDENT) |
| Authorized Official Telephone | 3096939540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| JAK Optical Laboratories | Doing Business As Name - Organization |
| Street Address |
8309 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508856923 | J A K Enterprises Inc | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2005-10-26 |
| 1063965515 | Laura Wilshire | Optometrist | 8309 N Knoxville Ave, Ste. 1, Peoria, IL 61615-2170 | 2016-08-02 |
| 1629319330 | Jak Enterprises, Inc | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2013-03-05 |
| 1942551619 | Jennifer M Schussele | Optometrist | 8309 N Knoxville Ave, Ste 1, Peoria, IL 61615-2170 | 2012-09-21 |
| 1851342588 | Barbara E. Ott | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598928707 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 9780 W Northern Ave Ste 1120, Peoria, AZ 85345-4607 | 2008-07-08 |
| 1518013200 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 4530 N. Brandywine Drive, Peoria, IL 61614 | 2007-01-26 |
| 1851441646 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 10140 N 91st Ave, Peoria, AZ 85345-8310 | 2007-01-12 |
| 1851457089 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 2200 W War Memorial Dr, Peoria Northwoods Mall, Peoria, IL 61613-1000 | 2006-12-30 |
| 1639245327 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4203 A1-a4 North Sheridan, Peoria, IL 61614-5951 | 2006-11-27 |
| 1073565180 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 2323 W Pioneer Pkwy, Peoria, IL 61615-1833 | 2006-05-17 |
| 1700336757 | Hw Holdings | Eyewear Supplier (Equipment, not the service) | 5116 N Big Hollow Rd, Peoria, IL 61615-3511 | 2016-10-13 |
| 1629261003 | See Optical | Eyewear Supplier (Equipment, not the service) | 9127 W Thunderbird Rd, #104, Peoria, AZ 85381-4887 | 2007-08-20 |
| 1801086780 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 24890 N Lake Pleasant Pkwy, Peoria, AZ 85383-1348 | 2007-07-27 |
| 1285779546 | Wyman Sicher Eye Associates Sc | Eyewear Supplier (Equipment, not the service) | 8921 N Wood Sage Rd, Peoria, IL 61615-7822 | 2007-02-21 |
| Find all providers in PEORIA | ||||
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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.