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Contact Information

EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC
1000 W DEYOUNG ST
MARION, IL62959-1630
 Phone: 618-993-0068
 Fax: 618-993-0968
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC

NPI # 1528020401
LBN Legal business name EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC
Authorized official DAVID ANDERSON - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/05/2006
Last updated 10/03/2007 - About 19 years ago
Identifiers
IL Other 10032015 BLUECROSS BLUESHIELD
IL Other CK8965 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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