JAK ENTERPRISES INC (NPI# 1164476354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164476354 |
| Entity Type | Organization |
| Organization Name | JAK ENTERPRISES INC |
| Other Organization Name | BARD OPTICAL |
| Practice Address |
3287 Court St Pekin IL 61554-6208 |
| Mailing Address |
8309 N Knoxville Ave Peoria IL 61615-2170 |
| Practice Telephone | 3093539313 |
| Practice Fax Number | 3093534962 |
| Mailing Telephone | 3096939540 |
| Mailing Fax Number | 3096939542 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-06-05 |
| 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 |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Bard Optical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548629256 | Jak Enterprises Inc | Durable Medical Equipment & Medical Supplies | 2409 N Dirksen Pkwy, Springfield, IL 62702-1404 | 2016-02-23 |
| 1588603138 | Jak Enterprises Inc | Optometrist | 8 Cherry Tree Shopping Ctr, Washington, IL 61571-2170 | 2006-06-06 |
| 1609815992 | Jak Enterprises Inc | Optometrist | 1351 Hickory Point Dr, Suite B, Forsyth, IL 62535-1085 | 2006-06-05 |
| 1598710345 | Jak Enterprises Inc | Optometrist | 1477 Woodlawn Rd, Lincoln, IL 62656 | 2006-05-23 |
| 1730134552 | Jak Enterprises Inc | Optometrist | 907 W Marketview Dr, Suite 15, Champaign, IL 61822-1227 | 2006-05-23 |
| 1275587420 | Jak Enterprises Inc | Optometrist | 3055 W Wabash, Springfield, IL 62704-6414 | 2006-05-20 |
| 1033163282 | Jak Enterprises Inc | Optometrist | 1265 N Henderson St, Galesburg, IL 61401-1510 | 2006-05-20 |
| 1932153186 | Jak Enterprises Inc | Optometrist | 1700 E College Ave Ste 3, Normal, IL 61761-6184 | 2006-05-20 |
| 1528012218 | Jak Enterprises Inc | Optometrist | 412 Riverside Dr, East Peoria, IL 61611-2098 | 2006-05-19 |
| 1760421317 | Jak Enterprises Inc | Optometrist | 1200 W Main St, Suite 21, Peoria, IL 61606-1253 | 2006-06-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | JAK ENTERPRISES INC. | 18 Buckingham Drive, Westford, MA 01886 |
| Virginia Business Entities | JAK Enterprises Inc. | 6303 Oleander Dr Ste 104b, Wilmington, North Carolina 28403-3577 |
| Street Address |
3287 COURT ST |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-6208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699762047 | Timothy Dane Shelley | Optometrist | 3287 Court St, Pekin, IL 61554-6208 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194279000 | Shauna L Bivens | Nurse Practitioner | 3400 Griffin Ave., Pekin, IL 61554 | 2016-08-09 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1366750671 | Dennis Kammerer Stoller | Dentist | 1608 Broadway, Pekin, IL 61554 | 2010-09-21 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1689856312 | Pekin Supportive Living Limited Patnership | Assisted Living Facility | 1320 Executive Court, Pekin, IL 61554 | 2007-12-05 |
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1376769638 | Debra Mollie Davis | Registered Nurse | 2079 Edgewater Dr, Pekin, IL 61554 | 2007-04-17 |
| 1649308230 | Tazewell County Health Department -dental Health Center | Public Health or Welfare | 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 | 2007-03-02 |
| 1528118239 | Jerry Lee Marshall | Dentist | 135a-b Radio City Drive, North Pekin, IL 61554 | 2007-01-12 |
| Find all providers in zip 61554 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801129150 | Gnl Merchandising | Durable Medical Equipment & Medical Supplies | 327 Derby St, Pekin, IL 61554-5651 | 2009-09-17 |
| 1457424079 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1607 Broadway St, Pekin, IL 61554-3805 | 2006-11-15 |
| 1780786160 | Midwest Eye Care PC | Durable Medical Equipment & Medical Supplies | 101 N Parkway Dr, Pekin, IL 61554-3932 | 2006-09-05 |
| 1376550301 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2020 Court St, Pekin, IL 61554-5215 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730250 | Quantum Prosthetics & Orthotics | Durable Medical Equipment & Medical Supplies | 9050 W 81st St Ste 300, Justice, IL 60458-1350 | 2020-11-05 |
| 1164022901 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 10090 Route 47, Huntley, IL 60142 | 2020-10-30 |
| 1003415514 | Brandon M Hudson | Durable Medical Equipment & Medical Supplies | 185 N Franklin St Fl 3, Chicago, IL 60606-1932 | 2020-10-26 |
| 1538768882 | Elect Logistics LLC | Durable Medical Equipment & Medical Supplies | 1318 S 61st Ave, Cicero, IL 60804-1011 | 2020-10-19 |
| 1679170757 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 5201 Walnut Ave Ste 6, Downers Grove, IL 60515-4071 | 2020-10-02 |
| 1588271910 | Cell Store One1 Inc | Durable Medical Equipment & Medical Supplies | 3727 Highknob Cir, Naperville, IL 60564-4423 | 2020-09-29 |
| 1689281131 | Chloe Powell | Durable Medical Equipment & Medical Supplies | 307 W Park Dr Apt B, Belleville, IL 62226-4753 | 2020-09-29 |
| 1083220396 | Aeroflow Inc. | Durable Medical Equipment & Medical Supplies | 210 N Hammes Ave Ste 103a, Joliet, IL 60435-6688 | 2020-09-22 |
| 1568077212 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 1206 East 9th Street, Ortho/spine Suite 103, Lockport, IL 60441-6044 | 2020-09-10 |
| 1295348084 | Windy City Rehab Specialists LLC | Durable Medical Equipment & Medical Supplies | 1530 S State St Ste C003, Chicago, IL 60605-2964 | 2020-08-31 |
| 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.