JAK ENTERPRISES, INC (NPI# 1629319330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629319330 |
| Entity Type | Organization |
| Organization Name | JAK ENTERPRISES, INC |
| Other Organization Name | BARD OPTICAL |
| Practice Address |
8309 N Knoxville Ave Peoria IL 61615-2170 |
| Practice Telephone | 3097133664 |
| Practice Fax Number | 3098390078 |
| Mailing Telephone | 3096939540 |
| Mailing Fax Number | 3096939542 |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | DIANA J. HALL (PRESIDENT) |
| Authorized Official Telephone | 3096939540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 046010457 | IL | Eye and Vision Services Providers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Bard Optical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295774859 | Jak Enterprises, Inc | Optometrist | 901 W Morton Ave, 113, Jacksonville, IL 62650-3145 | 2006-06-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | JAK ENTERPRISES, INC | 10906 E 6th Ave, Spokane, WA 99206 |
| Washington State Corporations | JAK ENTERPRISES, INC. | 601 S Pioneer Way Ste K, Moses Lake, WA 98837 |
| Street Address |
8309 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508856923 | J A K Enterprises Inc | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2005-10-26 |
| 1083158372 | Jak Enterprises Dba Jak Optical Laboratories | Eyewear Supplier (Equipment, not the service) | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2016-12-06 |
| 1063965515 | Laura Wilshire | Optometrist | 8309 N Knoxville Ave, Ste. 1, Peoria, IL 61615-2170 | 2016-08-02 |
| 1942551619 | Jennifer M Schussele | Optometrist | 8309 N Knoxville Ave, Ste 1, Peoria, IL 61615-2170 | 2012-09-21 |
| 1851342588 | Barbara E. Ott | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690112 | Sg Mechanical LLC | Durable Medical Equipment & Medical Supplies | 8550 N 91st Ave Ste E-51, Peoria, AZ 85345-8311 | 2020-02-11 |
| 1285272435 | Margaret A. Withrow, Dpm, PC | Durable Medical Equipment & Medical Supplies | 13660 N 94th Dr Ste A3, Peoria, AZ 85381-4836 | 2019-12-18 |
| 1003462581 | Bump Boxes, Inc | Durable Medical Equipment & Medical Supplies | 7719 N Pioneer Ln, Peoria, IL 61615-1910 | 2019-08-12 |
| 1023663010 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 9151 W Thunderbird Rd Ste 104, Peoria, AZ 85381-4906 | 2019-08-06 |
| 1851943286 | Banner Home Care Arizona | Durable Medical Equipment & Medical Supplies | 14131 N Rio Vista Blvd Ste 7, Peoria, AZ 85381-4917 | 2019-07-16 |
| 1093370108 | Osf Healthcare System | Durable Medical Equipment & Medical Supplies | 1800 N Knoxville Ave Ste 104, Peoria, IL 61603-3028 | 2019-05-03 |
| 1023584810 | Homestead Orthotics LLC | Durable Medical Equipment & Medical Supplies | 9401 W Thunderbird Rd Ste 187, Peoria, AZ 85381-4210 | 2018-10-18 |
| 1326552977 | Triage Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 10434 W Redbird Rd, Peoria, AZ 85383-3578 | 2017-11-17 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1144695883 | Game Day Medical, LLC | Durable Medical Equipment & Medical Supplies | 3004 W Playden Dr, Peoria, IL 61615-7505 | 2015-12-07 |
| Find all providers in PEORIA | ||||
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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.