J. Micetich, Od & Associates Family Eye Care Center P C
Optometrist in Coal City, IL. Organization (NPI-2).
NPI number1093832008
StatusActive
Last updated in NPPESSep 18, 2012
Details
- NPI
- 1093832008
- Entity type
- Organization (NPI-2)
- Legal business name
- J. Micetich, Od & Associates Family Eye Care Center P C
- Organization subpart
- No
- Enumeration date
- Mar 23, 2007
- Last updated
- Sep 18, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 046-008925 | IL | Yes |
Practice location
20 E North StCoal City, IL 60416-1087
Phone 815-634-4825
Mailing address
2920 Gateway GorgeMorris, IL 60450-9771
Phone 815-634-4825
Authorized official
Jonathan Edward Micetich
Optometrist
8156344825
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Other Optometrist providers in Coal City, IL
- Jennifer Wai-Ling Chu, O.D.NPI 1710326657
- Jonathan Edward Micetich, O.D.NPI 1740273754
- Myeyedr Optometry Of Illinois, LLCNPI 1972180149
- Abigail Rene NorrisNPI 1902489982
- Andrea Paradesi, O.D.NPI 1679021547
- Patricia Helen Simpson, O. D.NPI 1649274366
All 7 Optometrist providers in Coal City · All 97 providers in Coal City
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