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Contact Information

J A K ENTERPRISES INC
8309 N KNOXVILLE AVE
PEORIA, IL61615-2170
 Phone: 309-693-9540
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for J A K ENTERPRISES INC

NPI Number 1508856923
LBN Legal business name J A K ENTERPRISES INC
Authorized official DIANA HALL - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2005
Last updated 04/15/2025 - More than a year ago
Identifiers
IL Medicaid 1508856923
IL Other 7215175 BCBS
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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