Brian D Henson (NPI# 1184782112, PAC ID# 8325145683) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1184782112 |
| PAC ID by PECOS | 8325145683 |
| Professional Enrollment ID | I20070521000528 |
| Full Name | Brian D Henson |
| Organization Legal Name | JAK ENTERPRISES INC |
| Address |
1712 W Reynold Rd Pontiac IL 61764-9695 |
| Phone Number | 8154192019 |
| Gender | M |
| Credential | OD |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 1984 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 3173519014 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1712 W Reynold Rd, Pontiac, IL 61764-9695 | 8154192019 | JAK ENTERPRISES INC |
| Organization Legal Name | JAK ENTERPRISES INC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharna Annise Wiltz | Optometry | Jak Enterprises Inc | 3287 Court St, Pekin, IL 61554-6208 |
| Molly M Guithues | Optometry | Jak Enterprises Inc | 331 W 1st Dr, Decatur, IL 62521-5207 |
| Nicole M Jensen | Optometry | Jak Enterprises Inc | 1200 W Main St, Suite 21, Peoria, IL 61606-1218 |
| Rhonda Dameron | Optometry | Jak Enterprises Inc | 8309 N Knoxville Ave, Suite 1, Peoria, IL 61615-2171 |
| Steven H Lane | Optometry | Jak Enterprises Inc | 1351 Hickory Point Dr, B, Forsyth, IL 62535-1085 |
| Jeffrey S Heden | Optometry | Jak Enterprises Inc | 4032 46th Ave, Rock Island, IL 61201-7164 |
| John J Rimkus | Optometry | Jak Enterprises Inc | 3215 E Lincolnway, Sterling, IL 61081-1772 |
| Stacy A Twenhafel | Optometry | Jak Enterprises Inc | 907 W Marketview Dr, Champaign, IL 61822-1227 |
| David R Morgret | Optometry | Jak Enterprises Inc | 1265 N Henderson St, Galesburg, IL 61401-1510 |
| Joseph B Jackson | Optometry | Jak Enterprises Inc | 3323 Frontage Rd, Peru, IL 61354-1101 |
| Street Address |
1712 W REYNOLD RD |
| City | PONTIAC |
| State | IL |
| Zip | 61764-9695 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Bachman | Physical Therapy | Athletic and Therapeutic Institute of Bourbonnais, LLC | 924 W Custer Ave, Pontiac, IL 61764-1067 |
| Jordan Collins | Physical Therapy | Athletic and Therapeutic Institute of Bourbonnais, LLC | 924 W Custer Ave, Pontiac, IL 61764-1067 |
| Sasha Radford | Optometry | Pontiac Family Eye Care LLC | 320 N Ladd St, Pontiac, IL 61764-1612 |
| Bryan Stoller | Optometry | Pontiac Family Eye Care LLC | 320 N Ladd St, Pontiac, IL 61764-1612 |
| Janelle Joyce Brown | Optometry | Pontiac Family Eye Care LLC | 320 N Ladd St, Pontiac, IL 61764-1612 |
| Marcus S Deranian | Ophthalmology | Center for Sight of Central Illinois Sc | 608 W Ladd, Pontiac, IL 61764-1617 |
| Douglas R Watson | Optometry | 301 W Madison St, Pontiac, IL 61764-1705 | |
| Cheryle Diana Strother | Nurse Practitioner | 402 N Plum, Pontiac, IL 61764-1817 | |
| Kimberly K Kidner | Chiropractic | Livingston County Chiropractic Center, Ltd. | 402 N Plum St, Pontiac, IL 61764-1817 |
| Ashley N Fauser | Chiropractic | Livingston County Chiropractic Center, Ltd. | 402 N Plum St, Pontiac, IL 61764-1817 |
| Find all physicians in zip 61764 | |||
| City | PONTIAC |
| Zip Code | 61764 |
| Specialty | OPTOMETRY |
| City + Specialty | PONTIAC + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.