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Contact Information

KERN OPTOMETRIC ASSOCIATES PC
4408 N KNOXVILLE AVE
SUITE C
PEORIA, IL61614
 Phone: 309-682-6214
 Fax: 309-682-6236
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KERN OPTOMETRIC ASSOCIATES PC

NPI # 1598947343
LBN Legal business name KERN OPTOMETRIC ASSOCIATES PC
Authorized official RICHARD KERN - (OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2007
Last updated 05/07/2013 - About 13 years ago
Identifiers
IL License # 046007198
IL License # 0467198
IL Medicaid 046007198
Other 1497812242 NPI INDIVIDUAL CROSSOVER
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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