JAK ENTERPRISES INC (NPI# 1760421317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760421317 |
| Entity Type | Organization |
| Organization Name | JAK ENTERPRISES INC |
| Other Organization Name | BARD OPTICAL |
| Practice Address |
1200 W Main St Suite 21 Peoria IL 61606-1253 |
| Mailing Address |
8309 N Knoxville Ave Peoria IL 61615-2170 |
| Practice Telephone | 3096722273 |
| Practice Fax Number | 3096722274 |
| Mailing Telephone | 3096939540 |
| Mailing Fax Number | 3096939754 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-12-16 |
| 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 | 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 |
|---|---|---|---|---|
| 1548629256 | Jak Enterprises Inc | Durable Medical Equipment & Medical Supplies | 2409 N Dirksen Pkwy, Springfield, IL 62702-1404 | 2016-02-23 |
| 1588603138 | Jak Enterprises Inc | Optometrist | 8 Cherry Tree Shopping Ctr, Washington, IL 61571-2170 | 2006-06-06 |
| 1609815992 | Jak Enterprises Inc | Optometrist | 1351 Hickory Point Dr, Suite B, Forsyth, IL 62535-1085 | 2006-06-05 |
| 1598710345 | Jak Enterprises Inc | Optometrist | 1477 Woodlawn Rd, Lincoln, IL 62656 | 2006-05-23 |
| 1730134552 | Jak Enterprises Inc | Optometrist | 907 W Marketview Dr, Suite 15, Champaign, IL 61822-1227 | 2006-05-23 |
| 1275587420 | Jak Enterprises Inc | Optometrist | 3055 W Wabash, Springfield, IL 62704-6414 | 2006-05-20 |
| 1033163282 | Jak Enterprises Inc | Optometrist | 1265 N Henderson St, Galesburg, IL 61401-1510 | 2006-05-20 |
| 1932153186 | Jak Enterprises Inc | Optometrist | 1700 E College Ave Ste 3, Normal, IL 61761-6184 | 2006-05-20 |
| 1528012218 | Jak Enterprises Inc | Optometrist | 412 Riverside Dr, East Peoria, IL 61611-2098 | 2006-05-19 |
| 1790723542 | Jak Enterprises Inc | Optometrist | 4032 46th Ave, Rock Island, IL 61201-7164 | 2006-06-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | JAK ENTERPRISES INC. | 18 Buckingham Drive, Westford, MA 01886 |
| Virginia Business Entities | JAK Enterprises Inc. | 6303 Oleander Dr Ste 104b, Wilmington, North Carolina 28403-3577 |
| Street Address |
1200 W MAIN ST SUITE 21 |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306461637 | Kristin M Fouts | Pharmacist | 1200 W Main St, Peoria, IL 61606-1200 | 2020-06-12 |
| 1790072924 | Nicole M. Jensen | Optometrist | 1200 W Main St, Ste 21, Peoria, IL 61606-1200 | 2011-07-08 |
| 1649373317 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1200 W Main St, Peoria, IL 61606-1200 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| 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.