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ILLINOIS EXPRESS VISION CENTER-MATTOON INC.

Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

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Contact Information

ILLINOIS EXPRESS VISION CENTER-MATTOON INC.
420 BROADWAY AVE E
MATTOON, IL  61938-4604
 Phone: 217-235-1100
 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 ILLINOIS EXPRESS VISION CENTER-MATTOON INC.

NPI Number 1760508931
LBN Legal business name ILLINOIS EXPRESS VISION CENTER-MATTOON INC.
Authorized official STEVEN LANE - (OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 03/21/2007
Last updated 02/04/2013 - About 13 years ago
Identifiers
IL Other 01523250 BLUECROSS BLUE SHIELD ID#
IL Other IL7319 EYEMED PROVIDER NUMBER
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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