PAUL C JACOBS TREVOR CRABTREE PTR (NPI# 1619172368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619172368 |
Entity Type | Organization |
Organization Name | PAUL C JACOBS TREVOR CRABTREE PTR |
Other Organization Name | JACOBS & CRABTREE DCTRS OF OPTOMETRY |
Practice Address |
316 S Main St Anna IL 62906-1242 |
Mailing Address |
1508 Sioux Dr Marion IL 62959-5200 |
Practice Telephone | 6188333777 |
Practice Fax Number | 6188333777 |
Mailing Telephone | 6189938787 |
Mailing Fax Number | 6189976547 |
Enumeration Date | 2007-06-20 |
Last Update Date | 2014-12-17 |
Authorized Official Name | CAROLYN KELLER (MANAGER) |
Authorized Official Telephone | 6189938787 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
046-007399 | IL | Eye and Vision Services Providers |
Other Name | Type Code |
---|---|
JACOBS & CRABTREE DCTRS OF OPTOMETRY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649475328 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 223 N Park Ave, Herrin, IL 62948-3149 | 2007-06-20 |
1609072263 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1508 Sioux Dr, Marion, IL 62959-5209 | 2007-06-21 |
1558352641 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1001 N Beadle Dr, Ste 40, Carbondale, IL 62901-1018 | 2005-10-29 |
Street Address |
316 S MAIN ST |
City | ANNA |
State | IL |
Zip Code | 62906-1242 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841632874 | Celisha Ann Merriman | Optometrist | 316 S Main St, Anna, IL 62906-1242 | 2013-07-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265711600 | Community Integrated Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 110 Jeni Lane, Anna, IL 62906 | 2011-08-16 |
1508153768 | Union County Counseling Services Inc | Clinic/Center | 202 South St, Anna, IL 62906 | 2011-07-07 |
1326335589 | Union County Counseling Services Inc | Clinic/Center | 302 South St, Anna, IL 62906 | 2011-07-07 |
1063709228 | Union County Counseling Services Inc | Community Based Residential Treatment Facility, Mental Illness | 311 W Vienna St, Anna, IL 62906 | 2011-07-07 |
1598920928 | Steven Wayne Vincent | Dentist | 131 West Vienna Street, Anna, IL 62906 | 2008-07-24 |
1427236900 | Cardinal House Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 Douglas Street, Anna, IL 62906 | 2008-02-06 |
1992913719 | High Chiropractic Center | Chiropractor | 35 Walton Lane, Anna, IL 62906 | 2007-05-18 |
1023235678 | Chuck C. Bugle | Psychologist | 311 W. Spring St., Anna, IL 62906 | 2007-04-18 |
1922194604 | Nancy Kay Webb | Physical Therapist | 515 E Vienna Street, Suite I, Anna, IL 62906 | 2006-10-04 |
1144242918 | William W Mings | Psychiatry & Neurology | 204 South St, Anna, IL 62906 | 2006-07-24 |
Find all providers in zip 62906 |
Taxonomy Code | 152WC0802X |
Grouping | Eye and Vision Services Providers |
Classification | Optometrist |
Specialization | Corneal and Contact Management |
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
1225697675 | Park Ridge Vision LLC | Optometrist | 350 S Northwest Hwy Ste 104, Park Ridge, IL 60068-4262 | 2019-06-10 |
1679131213 | Union Eyes, LLC | Optometrist | 15900 W 127th St Ste 221, Lemont, IL 60439-2914 | 2019-05-29 |
1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
1588063572 | Northwestern Medical Faculty Foundation | Optometrist | 259 E. Erie Street, Suite#02-220, Chicago, IL 60611-2661 | 2014-08-15 |
1962734129 | Boyce Family Eye Care, Ltd. | Optometrist | 528 Devon Ave, Park Ridge, IL 60068-4820 | 2010-02-12 |
1558546713 | Halsted Eye Boutique, Inc. | Optometrist | 2852 N Halsted St, Chicago, IL 60657-6531 | 2008-01-07 |
1114119609 | Kapoor Vision Consultants, Ltd | Optometrist | 1221 W Talon Ct, Palatine, IL 60067-1848 | 2007-08-17 |
1649475328 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 223 N Park Ave, Herrin, IL 62948-3149 | 2007-06-20 |
1356559595 | Concept Eye Care, Ltd. | Optometrist | 1605 E 55th St, 1st Flr, Chicago, IL 60615-5803 | 2007-05-20 |
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.