DR. RYAN J WILSON (NPI# 1407832454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407832454 |
| Entity Type | Individual |
| Full Name | DR. RYAN J WILSON |
| Credential | O.D. |
| Practice Address |
422 South State Street Geneseo IL 61254-1536 |
| Mailing Address |
777 Tanglefoot Lane Eye Surgeons Associates P.C. Bettendorf IA 52722-1650 |
| Practice Telephone | 3099448893 |
| Practice Fax Number | 3099448893 |
| Mailing Telephone | 5633232020 |
| Mailing Fax Number | 5633285694 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 02270 | IA | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 046009598 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 046009598 | 05 | |
| IL GROUP MEDICARE | 977130 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796093 | Ryan Alan Wilson | Physical Therapist | 1020 Queensgate Dr Ste B, Richland, WA 99352-9123 | 2020-10-01 |
| 1346889359 | Ryan Wilson | Occupational Therapist | 8320 5th Ave Ne Ste A, Seattle, WA 98115-4174 | 2019-12-23 |
| 1326530007 | Ryan Wilson | Social Worker | 1900 E Northern Pkwy Ste 300, Baltimore, MD 21239-2113 | 2018-05-30 |
| 1679920482 | Ryan Scott Wilson | Dentist | 3706 Davis Stuart Rd, Lewisburg, WV 24901-9463 | 2016-05-22 |
| 1174908651 | Ryan Wilson | Social Worker | 1905 W 8th St, #209, Loveland, CO 80537-5224 | 2015-07-24 |
| 1780811984 | Ryan Hastiin Wilson | Dentist | 6810 Menaul Blvd Ne Ste B, Albuquerque, NM 87110 | 2009-06-15 |
| 1922094184 | Ryan D Wilson | Emergency Medicine | 800 24th Ave, Norman, OK 73069 | 2005-09-23 |
| 1679171342 | Ryan Zachary Wilson | Physical Therapist | 342 Fifth Ave, Pelham, NY 10803-1204 | 2020-10-14 |
| 1396343463 | Ryan Wilson | Case Manager/Care Coordinator | 1111 W Mockingbird Ln Ste 1030, Dallas, TX 75247-5028 | 2020-10-12 |
| 1124657556 | Ryan Wilson | Nurse Practitioner | 2761 Agnes Ln, Myrtle Beach, SC 29577-2029 | 2020-04-07 |
| Street Address |
422 SOUTH STATE STREET |
| City | GENESEO |
| State | IL |
| Zip Code | 61254-1536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891259362 | Allison J Blade | Nurse Practitioner | 600 N College Avenue Suite 120, Geneseo, IL 61254 | 2019-01-29 |
| 1477070258 | Aaron Thomas Wachtel, Dds | Dentist | 608 E. Ogden Avenue, Geneseo, IL 61254 | 2017-08-23 |
| 1558895722 | Triston Harry | Social Worker | 2707 17th Street, Rock Island, IL 61254 | 2017-04-14 |
| 1306392980 | Rebecca Woodard | Counselor | 2701 17 Street, Rock Island, IL 61254 | 2016-09-01 |
| 1164701082 | Kara Wiedenhoeft | Physical Therapist | 29 Meadowbrook Drive, Geneseo, IL 61254 | 2011-08-09 |
| 1982256301 | Jalyn April Salas | Occupational Therapy Assistant | 704 S Illinois St, Geneseo, IL 61254 | 2019-07-15 |
| 1306318001 | Ashley Mclaughlin | Social Worker | 2701 17th St, Rock Island, IL 61254 | 2018-12-19 |
| 1144747858 | Logan Hagerman | Counselor | 2701 17th St, Rock Island, IL 61254 | 2017-08-23 |
| 1013454677 | Amber Leanne Cozad | Counselor | 2701 17th St, Rock Island, IL 61254 | 2017-01-20 |
| 1457898173 | Paul Schmidt | Counselor | 2701 17th Street, Rock Island, IL 61254 | 2017-01-20 |
| Find all providers in zip 61254 | ||||
| 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 |
|---|---|---|---|---|
| 1841232899 | William A Bordwell | Optometrist | 112 S Center St, Geneseo, IL 61254-1338 | 2006-06-12 |
| 1013989292 | Michael J Dolan | Optometrist | 4384 Lakeville Rd, Geneseo, NY 14454-9761 | 2006-02-02 |
| 1609847011 | Danielle Lynne James | Optometrist | 4235 Veteran Dr, Geneseo, NY 14454-9433 | 2006-02-01 |
| 1023503893 | Geneseo Family Eye Care, LLC | Optometrist | 4384 Lakeville Rd, Geneseo, NY 14454-9761 | 2018-06-25 |
| 1205365293 | Wendel Vision Care Pllc | Optometrist | 4235 Veteran Dr, Geneseo, NY 14454-9442 | 2017-06-05 |
| 1073909354 | Vision Source Geneseo, LLC | Optometrist | 112 S Center St, Geneseo, IL 61254-1338 | 2015-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1124627880 | Biren Patel | Optometrist | 1330 N Larkin Ave, Joliet, IL 60435-3765 | 2020-10-22 |
| 1790392587 | Adriana Casillas | Optometrist | 11129 S Avenue J, Chicago, IL 60617-6910 | 2020-09-25 |
| 1033725114 | Sabrina D'haiti | Optometrist | 607 Oakton St, Evanston, IL 60202-5615 | 2020-09-23 |
| 1164037495 | Brett David Freitag | Optometrist | 5006 Northwest Hwy, Crystal Lake, IL 60014-7339 | 2020-09-14 |
| 1164036786 | Deeti Patel | Optometrist | 9053 Hollyberry Ave, Des Plaines, IL 60016-4216 | 2020-09-01 |
| 1497368252 | Gca Optical LLC | Optometrist | 1520 N Rock Run Dr Ste 2, Crest Hill, IL 60403-3172 | 2020-08-30 |
| 1538778097 | Opt Vision | Optometrist | 5371 W Lawrence Ave Ste A, Chicago, IL 60630-3695 | 2020-07-30 |
| 1578180147 | Ortizii PC | Optometrist | 111 N Wabash Ave Ste 1111, Chicago, IL 60602-3119 | 2020-06-30 |
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| 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.