DR. CHIH JEN WANG (NPI# 1861443079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861443079 |
| Entity Type | Individual |
| Full Name | DR. CHIH JEN WANG |
| Credential | O.D. |
| Practice Address |
1560 W Us Highway 50 O Fallon IL 62269-1619 |
| Mailing Address |
211 E Broadway Alton IL 62002-6220 |
| Practice Telephone | 6183976575 |
| Practice Fax Number | 8004326004 |
| Mailing Telephone | 8004072696 |
| Mailing Fax Number | 8004326004 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 2004001752 | MO | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 046-009615 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 046009615 | 05 | |
| IL | RR MEDICARE | P00403017 | 01 |
| Street Address |
1560 W US HIGHWAY 50 |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730232455 | Nu-crown, LLC | Optometrist | 1560 W Us Highway 50, O Fallon, IL 62269-1619 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| 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 |
|---|---|---|---|---|
| 1033534086 | Sherri Morris | Optometrist | 1350 W Highway 50, O Fallon, IL 62269-1615 | 2014-02-27 |
| 1215138805 | Sneha Lin | Optometrist | 2512 Highway K, O Fallon, MO 63368-6625 | 2007-05-30 |
| 1538211958 | Martin M Shulman | Optometrist | 100 W Pitman St, O Fallon, MO 63366-2819 | 2007-01-17 |
| 1285701581 | Charles Delano Signorelli | Optometrist | 2681 Highway K, O Fallon, MO 63366 | 2006-11-29 |
| 1386752681 | Kelli E Cadion Crago | Optometrist | 735 Insight Ave, O Fallon, IL 62269-2193 | 2006-08-27 |
| 1578515243 | Clarkson Optometry Inc | Optometrist | 933 Highway K, O Fallon, MO 63366-2910 | 2006-05-17 |
| 1760450696 | John J. Konopik | Optometrist | 361 Winding Woods Ctr, O Fallon, MO 63366-4170 | 2006-03-08 |
| 1982693297 | Lisa Marie Mackey | Optometrist | 3013 Winghaven Blvd, O Fallon, MO 63368-3600 | 2005-10-19 |
| 1649263856 | Joseph P Hegyi | Optometrist | 4142 Keaton Crossing Blvd, Suite 103, O Fallon, MO 63368-8404 | 2005-08-24 |
| 1467459057 | David Sassouni Eghigian | Optometrist | 1003 E Wesley Dr, Ste A, O Fallon, IL 62269-6137 | 2005-06-28 |
| Find all providers in O FALLON | ||||
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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.