EYE BOUTIQUE INC (NPI# 1396883401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396883401 |
| Entity Type | Organization |
| Organization Name | EYE BOUTIQUE INC |
| Other Organization Name | HEARTLAND VISION |
| Practice Address |
2524 W Farrelly Ave Peoria IL 61615-3650 |
| Mailing Address |
16800 West Cleveland Ave New Berlin WI 53151-3533 |
| Practice Telephone | 3096814679 |
| Practice Fax Number | 2629237677 |
| Mailing Telephone | 2624322005 |
| Mailing Fax Number | 2624322006 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-10-22 |
| Authorized Official Name | MR. DARREN THOMAS HORNDASCH (PRESIDENT/CEO) |
| Authorized Official Telephone | 2624322005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SPECTERA PROVIDER NO. | 21449 | 01 | |
| IL | DAVIS VISION | 07885 | 01 |
| Other Name | Type Code |
|---|---|
| Heartland Vision | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659529436 | Eye Boutique Inc | Optometrist | 1273 S Naper Blvd, Naperville, IL 60540-8300 | 2008-09-04 |
| 1679721591 | Eye Boutique Inc | Optometrist | 5005 Northwest Hwy, Crystal Lake, IL 60014-7330 | 2008-09-04 |
| 1487802260 | Eye Boutique Inc | Optometrist | 2509 County Line Rd, Algonquin, IL 60102-2566 | 2008-09-04 |
| 1720236805 | Eye Boutique Inc | Optometrist | 2239 W. Jefferson Street, Joliet, IL 60435-6303 | 2008-09-03 |
| 1114144276 | Eye Boutique Inc | Eyewear Supplier (Equipment, not the service) | 1839 W Irving Park Rd, Schaumburg, IL 60193-3509 | 2007-04-19 |
| 1972832012 | Eye Boutique Inc | Optometrist | 8800 W Dempster St, Niles, IL 60714-5109 | 2009-12-21 |
| 1851549638 | Eye Boutique Inc | Optometrist | 1622 Commons Drive, Geneva, IL 60134 | 2008-09-04 |
| Street Address |
2524 W FARRELLY AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-3650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578808911 | John J Chobanian | Hearing Instrument Specialist | 2524 W Farrelly Ave, Suite F, Peoria, IL 61615-3650 | 2012-12-11 |
| 1134472731 | Connect Hearing, Inc. | Audiologist | 2524 W Farrelly Ave, Suite F, Peoria, IL 61615-3650 | 2012-10-19 |
| 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 | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
| 1487175741 | Mark William Wellman | Optometrist | 18431 N 91st Ave Ste 1, Peoria, AZ 85382-0817 | 2017-06-27 |
| 1255674313 | John M. Rinehart, O.d., P.C. | Optometrist | 13260 N 94th Dr Ste 420, Peoria, AZ 85381-4241 | 2013-03-27 |
| 1811272263 | Kevin Michael Ryan | Optometrist | 5201 W War Memorial Dr, Peoria, IL 61615-9222 | 2011-10-17 |
| 1912212960 | Macarius, Max & Daniel, LLC | Optometrist | 2415 W Glen Ave, Peoria, IL 61614-4533 | 2010-08-15 |
| 1922242379 | John P Gysin Od | Optometrist | 5901 N Prospect Rd Ste 11, Peoria, IL 61614-4337 | 2009-04-29 |
| 1912169962 | Timothy G. Cundiff | Optometrist | 4900 N Glen Park Place Rd Ste C, Peoria, IL 61614-4685 | 2008-07-01 |
| 1316098791 | Jackson Romaine Bennett Jr. | Optometrist | 4530 N Brandywine Dr, Eyeglass World 12, Peoria, IL 61614-5570 | 2007-01-14 |
| 1487713160 | Christopher James Parot | Optometrist | 15256 N.75th Ave., Suite 380, Peoria, AZ 85381 | 2006-12-08 |
| 1225196827 | Richard Scott Stewart | Optometrist | 10006 W Happy Valley Rd, #1250, Peoria, AZ 85383-1235 | 2006-12-05 |
| 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.