DR. EVELYN MARIE MOORE (NPI# 1497826655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497826655 |
| Entity Type | Individual |
| Full Name | DR. EVELYN MARIE MOORE |
| Credential | O.D. |
| Practice Address |
2032 N Prospect Ave Champaign IL 61822-1240 |
| Practice Telephone | 2179541085 |
| Practice Fax Number | 2176075457 |
| Mailing Telephone | 2179541085 |
| Mailing Fax Number | 2176075457 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2016-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046.006881 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 0001084006 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952693392 | Evelyn J Moore | Behavioral Analyst | 1218 Griegos Rd Nw, Albuquerque, NM 87107-3752 | 2011-05-04 |
| 1801123351 | Evelyn L Moore | Registered Nurse | 400 N Pepper Ave, Colton, CA 92324-1801 | 2009-11-04 |
| 1154577286 | Evelyn Moore | Licensed Practical Nurse | 87 Washington St, Rensselaer, NY 12144-2613 | 2008-08-08 |
| Street Address |
2032 N PROSPECT AVE |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822-1240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023411691 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2032 N Prospect Ave, Champaign, IL 61822-1240 | 2014-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| 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 |
|---|---|---|---|---|
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| 1801142351 | Jeffrey Lewis | Optometrist | 507 W Town Center Blvd, Champaign, IL 61822-1248 | 2012-08-01 |
| 1750616132 | The Eye Center | Optometrist | 403 Windsor Rd, Champaign, IL 61820-7722 | 2009-10-02 |
| 1235257544 | Sara Jo Meyer | Optometrist | 2008 Round Barn Rd, Champaign, IL 61821-3623 | 2007-03-26 |
| 1619013117 | Kelly Alice Sanders | Optometrist | 518 E Green St, Illini Eyecare Express, Champaign, IL 61820 | 2007-01-30 |
| 1790850345 | Kevin Lee Glancy | Optometrist | 2000 N Neil St, Champaign, IL 61820-7808 | 2006-11-21 |
| 1861562530 | Michael Garrett Balgemann | Optometrist | 2515 N Prospect Ave, Suite 100, Champaign, IL 61822-1226 | 2006-11-09 |
| 1194827642 | Lawrence Howard Kessler | Optometrist | 44 E. Main Street, Suit 100, Champaign, IL 61820-3636 | 2006-09-04 |
| 1730134552 | Jak Enterprises Inc | Optometrist | 907 W Marketview Dr, Suite 15, Champaign, IL 61822-1227 | 2006-05-23 |
| 1689644684 | Erik Duane Burgwald | Optometrist | 1711 S Neil St, Champaign, IL 61820 | 2006-01-24 |
| Find all providers in CHAMPAIGN | ||||
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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.