WENDY'S EYEGLASS SHACK, INC. (NPI# 1104081587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104081587 |
| Entity Type | Organization |
| Organization Name | WENDY'S EYEGLASS SHACK, INC. |
| Practice Address |
8424 N Knoxville Ave Peoria IL 61615-2032 |
| Practice Telephone | 3096930100 |
| Mailing Telephone | 3096930100 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2010-09-21 |
| Authorized Official Name | WENDY RUTH SMITH (CERTIFIED OPTICIAN) |
| Authorized Official Telephone | 3096930100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
136295 | IL | Eye and Vision Services Providers |
| Street Address |
8424 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770761306 | Wendy Smith | Technician/Technologist | 8424 N Knoxville Ave, Peoria, IL 61615-2032 | 2008-02-06 |
| 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 | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184959777 | America's Best Contacts & Eyeglasses | Technician/Technologist | 5201 W War Memorial Dr Ste 565, Peoria, IL 61615-9280 | 2009-10-15 |
| 1205077617 | Nationwide Vision Center, LLC | Technician/Technologist | 24654 N Lake Pleasant Pkwy, Suite 102, Peoria, AZ 85383-1359 | 2009-03-13 |
| 1770761306 | Wendy Smith | Technician/Technologist | 8424 N Knoxville Ave, Peoria, IL 61615-2032 | 2008-02-06 |
| 1609075985 | Bond Eye Associates, S.c. | Technician/Technologist | 6800 N Knoxville Ave, Peoria, IL 61614-2842 | 2007-07-16 |
| 1417027087 | Nationwide Vision Center, LLC | Technician/Technologist | 9069 W Olive Ave, Suite 112, Peoria, AZ 85345-9124 | 2006-11-09 |
| 1225108442 | Nationwide Vision Center, LLC | Technician/Technologist | 8215 W Bell Rd, Suite 122, Peoria, AZ 85382-3800 | 2006-11-08 |
| 1689849416 | Wal-mart Stores, Inc. | Technician/Technologist | 21655 N Lake Pleasant Pkwy, Peoria, AZ 85382-7436 | 2008-04-23 |
| 1134243009 | Kenn Rosek | Technician/Technologist | 13660 N 94th Dr Ste A2, Peoria, AZ 85381-4836 | 2007-03-18 |
| 1245354117 | Optical Experts Inc | Technician/Technologist | 13660 N 94th Dr Ste A2, Peoria, AZ 85381-4836 | 2007-03-18 |
| 1982788535 | Wal-mart Stores, Inc | Technician/Technologist | 8915 N Allen Rd, Peoria, IL 61615-1534 | 2006-10-24 |
| 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.