EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC (NPI# 1528020401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528020401 |
| Entity Type | Organization |
| Organization Name | EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC |
| Other Organization Name | KIES EYE CENTER |
| Practice Address |
1000 W Deyoung St Marion IL 62959-1630 |
| Mailing Address |
1429 N Mount Auburn Rd Cape Girardeau MO 63701-2171 |
| Practice Telephone | 6189930068 |
| Practice Fax Number | 6189930968 |
| Mailing Telephone | 5733359175 |
| Mailing Fax Number | 5733343390 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | DAVID C ANDERSON (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 5733359175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUECROSS BLUESHIELD | 10032015 | 01 |
| IL | RAILROAD MEDICARE | CK8965 | 01 |
| Other Name | Type Code |
|---|---|
| Kies Eye Center | Doing Business As Name - Organization |
| Street Address |
1000 W DEYOUNG ST |
| City | MARION |
| State | IL |
| Zip Code | 62959-1630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861592065 | Luis A Lopez | Specialist | 1000 W Deyoung St, Marion, IL 62959-1630 | 2006-09-25 |
| 1053413740 | Heartland Pediatric Clinic | Pediatrics | 1000 W Deyoung St, Marion, IL 62959-1630 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417119488 | Michael Alan Morris | Ophthalmology | 8341 Express Dr Ste C, Marion, IL 62959-6476 | 2008-06-30 |
| 1205952249 | Omar Rizwan Ahmad | Ophthalmology | 1200 W Deyoung, Marion, IL 62959 | 2007-03-21 |
| 1295701118 | Deanna Jende Stevens | Ophthalmology | 1462 Marion Waldo Rd, Marion, OH 43302-7422 | 2006-02-28 |
| 1336137751 | Stokes Regional Eye Center | Ophthalmology | 3032 E Highway 76, Marion, SC 29571 | 2005-10-10 |
| 1770978645 | Nicholas Moore | Ophthalmology | 1462 Marion Waldo Rd, Marion, OH 43302 | 2015-03-30 |
| 1740384189 | Irene Fedorovich | Ophthalmology | 2401 W Main St, Marion, IL 62959-1188 | 2006-09-07 |
| 1700823010 | John Charles Garvin | Ophthalmology | 1040 Delaware Avenue, Marion, OH 43301-1814 | 2006-06-02 |
| 1053369207 | Gary D Burton | Ophthalmology | 1040 Delaware Avenue, Marion, OH 43301-1814 | 2006-05-04 |
| 1104889716 | Midwest Eye Consultants, P.C. | Ophthalmology | 1800 N Wabash Rd, Suite 100, Marion, IN 46952-1300 | 2006-04-07 |
| 1518933571 | Steven Michael Kirkham | Ophthalmology | 1462 Marion Waldo Rd, Marion, OH 43302-7422 | 2006-02-28 |
| Find all providers in MARION | ||||
Please comment or provide details below to improve the information on EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC.
| 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.