HOMER A FERGUSON, JR, MD, PC (NPI# 1790728012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790728012 |
| Entity Type | Organization |
| Organization Name | HOMER A FERGUSON, JR, MD, PC |
| Practice Address |
3990 N Illinois Swansea IL 62226 |
| Practice Telephone | 6182771130 |
| Practice Fax Number | 6182776651 |
| Mailing Telephone | 6182771130 |
| Mailing Fax Number | 6182776651 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-11-20 |
| Authorized Official Name | HOMER A FERGUSON II (OWNER) |
| Authorized Official Telephone | 6182771130 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1100X |
Technician/Technologist Specialization: Ophthalmic |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NPI INDIVIDUAL | 1225033178 | 01 |
| Street Address |
3990 N ILLINOIS |
| City | SWANSEA |
| State | IL |
| Zip Code | 62226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295778587 | Jfj Eyecare Ltd | Optometrist | 3990 N Illinois, Swansea, IL 62226 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 156FX1100X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ophthalmic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255374559 | Illinois Retina Surgery Ltd | Technician/Technologist | 3990 N Illinois St, Swansea, IL 62226-1919 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760979736 | Emerging Vision Inc | Technician/Technologist | 520 N. Michigan Ave, The Shops North Bridge, Ste 124, Chicago, IL 60611 | 2018-04-16 |
| 1033353644 | Gailey Eye Clinic, Ltd | Technician/Technologist | 2435 Village Green Pl, Champaign, IL 61822-7676 | 2009-04-27 |
| 1083819718 | Gailey Eye Clinic, Ltd | Technician/Technologist | 47 E Liberty Ln, Danville, IL 61832-1440 | 2007-06-21 |
| 1184829814 | Gailey Eye Clinic, Ltd | Technician/Technologist | 322 W Marion Ave, Forsyth, IL 62535-1064 | 2007-06-21 |
| 1275738908 | Gailey Eye Clinic, Ltd | Technician/Technologist | 4927 N Glen Park Place Rd, Peoria, IL 61614-4676 | 2007-06-21 |
| 1487859401 | Gailey Eye Clinic, Ltd | Technician/Technologist | 2121 Marquette Rd, Peru, IL 61354-1588 | 2007-06-19 |
| 1467582460 | Robert S. Baller, Md,pc | Technician/Technologist | 210 1-2 N Williamsburg Drive, Bloomington, IL 61704 | 2007-03-07 |
| 1285794362 | Tatjana K Pavlovic | Technician/Technologist | 2719 W Peterson Ave, Chicago, IL 60659-3919 | 2006-12-11 |
| 1861509051 | Joseph E Frydman, Md,sc | Technician/Technologist | 2634 Grand Ave Ste 201, Waukegan, IL 60085-2460 | 2006-08-24 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 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.