MR. RANDY L LIGHT (NPI# 1124060074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124060074 |
| Entity Type | Individual |
| Full Name | MR. RANDY L LIGHT |
| Credential | B.C.O., B.A.D.O. |
| Practice Address |
1318 W Candletree Dr Suite 3 Peoria IL 61614-8508 |
| Practice Telephone | 3096763663 |
| Practice Fax Number | 3096760359 |
| Mailing Telephone | 3096763663 |
| Mailing Fax Number | 3096760359 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1700X |
Technician/Technologist Specialization: Ocularist |
203.000116 | IL | Eye and Vision Services Providers |
| Street Address |
1318 W CANDLETREE DR SUITE 3 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-8508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972550390 | Lights Prosthetic Eyes Inc | Technician/Technologist | 1318 W Candletree Dr, Ste 3, Peoria, IL 61614-8509 | 2006-05-30 |
| 1952475378 | James Lynn Davis | Dentist | 1318 W Candletree Dr, Suite 2, Peoria, IL 61614-8508 | 2006-11-17 |
| 1083708648 | Brian R Degise | Dentist | 1318 W Candletree Dr, Peoria, IL 61614-1586 | 2006-10-03 |
| 1447294483 | Benjamin Leroy Light | Technician/Technologist | 1318 W Candletree Dr, Suite 3, Peoria, IL 61614-8508 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 156FX1700X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ocularist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972550390 | Lights Prosthetic Eyes Inc | Technician/Technologist | 1318 W Candletree Dr, Ste 3, Peoria, IL 61614-8509 | 2006-05-30 |
| 1447294483 | Benjamin Leroy Light | Technician/Technologist | 1318 W Candletree Dr, Suite 3, Peoria, IL 61614-8508 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922432731 | Magdy Mina | Technician/Technologist | 1525c Ogden Ave, Downers Grove, IL 60515 | 2013-08-28 |
| 1396019469 | Beverly Woltman | Technician/Technologist | 6800 S. Main Street, Suite Ll5, Downers Grove, IL 60516 | 2012-03-06 |
| 1184783227 | Patrick Adkins | Technician/Technologist | 2434 E Dempster St, #206, Des Plaines, IL 60016-5316 | 2006-12-06 |
| 1902156896 | Artistic Eye, LLC | Technician/Technologist | 6800 S. Main Street, Suite Ll-5, Downers Grove, IL 60516-3593 | 2012-09-18 |
Please comment or provide details below to improve the information on MR. RANDY L LIGHT.
| 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.