EYEDENTITY VISION CARE, LLC (NPI# 1538350228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538350228 |
| Entity Type | Organization |
| Organization Name | EYEDENTITY VISION CARE, LLC |
| Practice Address |
309 Hamilton St Ste A Geneva IL 60134-2182 |
| Practice Telephone | 6302324211 |
| Practice Fax Number | 6302327636 |
| Mailing Telephone | 6302324211 |
| Mailing Fax Number | 6302327636 |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2014-12-16 |
| Authorized Official Name | DR. THOMAS J CARR (PRESIDENT) |
| Authorized Official Telephone | 6302324211 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046-008336 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 04532377 | 01 |
| Street Address |
309 HAMILTON ST STE A |
| City | GENEVA |
| State | IL |
| Zip Code | 60134-2182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403918 | Glenda Creighton | Physical Therapist | 0n 801 Friendship Way, Geneva, IL 60134 | 2020-10-02 |
| 1467912212 | Cierra Monae French | Family Medicine | Northwestern Medicine Delnor Hospital, 300 Randall Road, Geneva, IL 60134 | 2019-03-20 |
| 1497246227 | Linda Huber | Psychologist | 1541 E Fabyan Pkwy Ste 101, Geneva, IL 60134 | 2018-05-29 |
| 1003305459 | Nicole Collins | Specialist/Technologist | 1125 Lewis Road, Geneva, IL 60134 | 2018-05-01 |
| 1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
| 1982142980 | Samantha Courtney | Counselor | 1120 Randall Ct., Geneva, IL 60134 | 2017-02-09 |
| 1073055026 | Physical Rehabilitation Clinics | Physical Therapist | 507 S. 3rd St. Unit I, Geneva, IL 60134 | 2016-11-08 |
| 1265868707 | Gina Marie Gilchrist | Dietitian, Registered | 39w479 W Haladay Ln, Geneva, IL 60134 | 2013-09-16 |
| 1770823585 | William A. Goodfellow | General Practice | 1010 S. Batavia Ave., Geneva, IL 60134 | 2013-02-15 |
| 1467705392 | Kylie L Mack | Physician Assistant | 351 Delnor Dr #100, Geneva, IL 60134 | 2012-10-16 |
| Find all providers in zip 60134 | ||||
| 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 |
|---|---|---|---|---|
| 1881971133 | Third Street Eyecare, Ltd | Optometrist | 500 S Third St, Ste 105, Geneva, IL 60134-2762 | 2011-11-14 |
| 1033367040 | Paul H Bastermajian | Optometrist | 1622 Commons Dr, Geneva, IL 60134-2531 | 2008-09-03 |
| 1447433057 | Florianne Pacheco Burns | Optometrist | 507 S 3rd St Ste Fs, Geneva, IL 60134-2730 | 2007-12-06 |
| 1154456671 | Michael Thomas Tweed | Optometrist | 1749 S Randall Rd Ste F, Pearle Vision Center, Geneva, IL 60134-4616 | 2007-02-23 |
| 1346390499 | Industrial Optical Service, Inc. | Optometrist | 507 S 3rd St, Suite F, Geneva, IL 60134-2730 | 2007-01-11 |
| 1437213907 | John D. Clark | Optometrist | Clark Eye Care Center, 81 North St, Geneva, NY 14456 | 2006-12-20 |
| 1255491874 | Linda M. Zanas | Optometrist | 1492-g S. Randall Rd., Geneva, IL 60134 | 2006-12-12 |
| 1336225135 | Richard C Judycki II | Optometrist | 1622 Commons Drive, Geneva, IL 60134 | 2006-10-27 |
| 1699855569 | Michele Montalbano | Optometrist | 2197 Blackberry Dr Ste A, Geneva, IL 60134-4713 | 2006-10-16 |
| 1942399274 | Christopher I Main | Optometrist | 809 Canandaigua Rd, Geneva, NY 14456-2003 | 2006-10-12 |
| Find all providers in GENEVA | ||||
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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.