FAMILY EYE CARE SOUTHPARK (NPI# 1629198585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629198585 |
| Entity Type | Organization |
| Organization Name | FAMILY EYE CARE SOUTHPARK |
| Practice Address |
4703 16th St Moline IL 61265-7066 |
| Practice Telephone | 3097623937 |
| Mailing Telephone | 3097623937 |
| Enumeration Date | 2007-04-01 |
| Last Update Date | 2008-08-11 |
| Authorized Official Name | ROBERT BENTLY WOODHAM (OWNER) |
| Authorized Official Telephone | 3097623937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1699 | IA | Eye and Vision Services Providers |
| Street Address |
4703 16TH ST |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-7066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710933668 | Qiang Zhang | Chiropractor | 4703 16th St, Moline, IL 61265-7066 | 2006-05-25 |
| 1063810109 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4703 16th St, Moline, IL 61265-7066 | 2014-12-05 |
| 1639212384 | Eyemart Express, Ltd. | Durable Medical Equipment & Medical Supplies | 4703 16th St, Suite B, Moline, IL 61265-7066 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| 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 |
|---|---|---|---|---|
| 1649428970 | Gregory M New | Optometrist | 4500 16th St Ste 100, Moline, IL 61265-7068 | 2008-08-28 |
| 1700914504 | Nicole C Sidock | Optometrist | 4406 16th St, Moline, IL 61265-7012 | 2007-03-01 |
| 1043283146 | Sara R Kurtis | Optometrist | 3930 44th Avenue Dr, Moline, IL 61265-6401 | 2006-02-09 |
| 1306409107 | Vep Il Optometric LLC | Optometrist | 4406 16th St, Moline, IL 61265-7012 | 2019-04-17 |
| 1689761900 | Nokhram Boodhoo | Optometrist | 4351 16th St, Moline, IL 61265-7009 | 2006-10-06 |
| 1518078989 | Brent C Nielsen | Optometrist | 4540 3rd St, The Eye Center, Moline, IL 61265-6104 | 2006-08-31 |
| 1679681829 | Francis M Loomis II | Optometrist | 550 30th Ave, Ste #1, Moline, IL 61265-5975 | 2006-08-28 |
| 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.