DR. DOUGLAS S. BULL (NPI# 1083621544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083621544 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS S. BULL |
| Credential | M.D. |
| Practice Address |
3101 Fields South Dr Champaign IL 61822-3743 |
| Mailing Address |
101 W University Ave Champaign IL 61820-3909 |
| Practice Telephone | 2173661250 |
| Mailing Telephone | 2173661250 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 036-097796 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036097796 1 | 05 | |
| IL | RAILROAD MEDICARE | 180045279 | 01 |
| IL | MEDICARE GROUP | 279500 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851716906 | Douglas John Bull | Physical Therapy Assistant | 900 Ash Dr, Colona, IL 61241-9549 | 2014-02-26 |
| 1023066255 | Douglas Middleton Bull | Radiology | 1519 Marion St, Columbia, SC 29220-0001 | 2006-05-04 |
| Street Address |
3101 FIELDS SOUTH DR |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822-3743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750386215 | Nathan A Crouch | Optometrist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2005-06-20 |
| 1255961470 | Kyle Kappes | Student in an Organized Health Care Education/Training Program | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2020-01-16 |
| 1356897003 | Emily Foertsch | Nurse Practitioner | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2016-08-31 |
| 1467858308 | Kelly Mae Guzlas | Registered Nurse | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2014-11-04 |
| 1811257348 | Samantha Herriott | Physical Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2012-05-17 |
| 1861791261 | Karen Valerie Draper | Internal Medicine | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2011-03-24 |
| 1841517679 | Lisa Ryan Hobbs | Podiatrist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2010-05-04 |
| 1497940993 | Dara Naomi Catron | Occupational Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2007-09-09 |
| 1831311984 | Amit Date | Otolaryngology | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2007-05-02 |
| 1356560353 | Christine Benway | Physical Therapist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2007-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073694303 | James Robert Kresca | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2006-10-17 |
| 1104918176 | Samir I. Sayegh | Ophthalmology | 2151 S Neil St, Champaign, IL 61820-7593 | 2006-09-28 |
| 1386612927 | Bette L Anderson | Ophthalmology | 3015 Village Office Pl, Champaign, IL 61822-7674 | 2006-03-09 |
| 1710321310 | Ruidi Wang | Ophthalmology | 3105 Fields South Dr, Champaign, IL 61822-3743 | 2013-04-25 |
| 1598908733 | Roger Ewald | Ophthalmology | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2009-04-17 |
| 1700927597 | Kresca Eye Clinic,ltd. | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2007-02-12 |
| 1760572085 | Frank Joseph Kresca | Ophthalmology | 2011 Round Barn Rd, Champaign, IL 61821-6825 | 2006-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433473 | Chicagoland Eye Consultants, Sc | Ophthalmology | 477 E Butterfield Rd Ste 101, Lombard, IL 60148-4880 | 2020-09-30 |
| 1649894189 | Lakeshore Ophthalmology, LLC | Ophthalmology | 2525 S Michigan Ave Fl 8, Chicago, IL 60616-2315 | 2020-06-01 |
| 1053940460 | Neil L Ross | Ophthalmology | 950 N Michigan Ave Apt 5403, Chicago, IL 60611-7535 | 2020-04-07 |
| 1932730256 | Cereesa E. Longest Md Sc | Ophthalmology | 225 Oak Knoll Rd, Barrington, IL 60010-2615 | 2020-01-27 |
| 1497314181 | Ophthalmology Surgery Center of Illinois, LLC | Ophthalmology | 1300 N Arlington Heights Rd Ste 150, Itasca, IL 60143-3128 | 2019-06-06 |
| 1770149049 | Rop Consultants LLC | Ophthalmology | 5228 N Virginia Ave, Chicago, IL 60625-4015 | 2019-05-13 |
| 1962969881 | Monique Munro | Ophthalmology | 1855 W Taylor Street. Suite 3138 Illinois Eye and Infir, Chicago, IL 60612 | 2019-02-27 |
| 1679039457 | Laser and Cataract Institute, LLC | Ophthalmology | 22200 Wolf Rd, Frankfort, IL 60423-7721 | 2019-02-15 |
| 1063987345 | Chataam Optical LLC | Ophthalmology | 8741 S Greenwood Ave Ste 108, Chicago, IL 60619-7058 | 2018-10-12 |
| 1922507474 | Dekalb Eye Consultants, LLC | Ophthalmology | 1075 Featherstone Rd Ste 10, Rockford, IL 61107-5906 | 2018-02-09 |
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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.