ILLINOIS CORRECTIONAL INDUSTRIES (NPI# 1780809285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780809285 |
| Entity Type | Organization |
| Organization Name | ILLINOIS CORRECTIONAL INDUSTRIES |
| Practice Address |
2600 N Brinton Ave Dixon IL 61021-9532 |
| Mailing Address |
Po Box 19277 1301 Concordia Court Springfield IL 62794-9277 |
| Practice Telephone | 8152883010 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | MR. JAMES UNDERWOOD (CEO) |
| Authorized Official Telephone | 2175222666 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 100042652001 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ILLINOIS CORRECTIONAL INDUSTRIES | 1301 Concordia Court Cushman Bldg, Springfield, IL 62794-5643 |
| Street Address |
2600 N BRINTON AVE |
| City | DIXON |
| State | IL |
| Zip Code | 61021-9532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104287630 | Kristina Kay Mershon | Nurse Practitioner | 2600 N Brinton Ave, Dixon, IL 61021-9532 | 2016-03-10 |
| 1235518580 | James Hagler | Counselor | 2600 N Brinton Ave, Dixon, IL 61021-9532 | 2015-05-20 |
| 1699912063 | Arin N Alberts | Psychologist | 2600 N Brinton Ave, Dixon, IL 61021-9532 | 2009-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1700838729 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1350 N Galena Ave, Dixon, IL 61021-1010 | 2006-05-17 |
| 1487975603 | Ksb Medical Group, Inc. | Eyewear Supplier (Equipment, not the service) | 511 Palmyra St, Dixon, IL 61021-1953 | 2010-06-22 |
| 1306814603 | Ksb Medical Group, Inc. | Eyewear Supplier (Equipment, not the service) | 102 S Hennepin Ave, Dixon, IL 61021-3083 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1972129294 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 900 W North Ave, Chicago, IL 60642-2506 | 2020-06-23 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| 1710512488 | Glasses On Oak St | Eyewear Supplier (Equipment, not the service) | 900 N Michigan Ave Fl 5, Chicago, IL 60611-1542 | 2020-03-03 |
| 1861026890 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 5300 Northwest Hwy, Crystal Lake, IL 60014-8072 | 2020-02-28 |
| 1952935181 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4999 Old Orchard Ctr Ste J4, Skokie, IL 60077-1450 | 2020-02-26 |
| 1194355917 | Fr Vision 360, Inc. | Eyewear Supplier (Equipment, not the service) | 111 E Morton Ave, Jacksonville, IL 62650-3059 | 2020-01-21 |
| 1114567443 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 6215 Northwest Hwy, Crystal Lake, IL 60014-7932 | 2020-01-15 |
| 1841833399 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | Milwaukee Ave & E Towline Rd #e1600, Vernon Hills, IL 60061 | 2019-10-28 |
| 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.