Illinois Physicians Eyecare Group, S.C.
Optometrist in Peoria, IL. Organization (NPI-2).
NPI number1669942884
StatusActive
Last updated in NPPESJun 23, 2026
Details
- NPI
- 1669942884
- Entity type
- Organization (NPI-2)
- Legal business name
- Illinois Physicians Eyecare Group, S.C.
- Organization subpart
- No
- Enumeration date
- Nov 30, 2018
- Certification date
- Jun 23, 2026
- Last updated
- Jun 23, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
2415 W Glen AvePeoria, IL 61614-4533
Phone 309-966-1236 · Fax 309-693-2131
Mailing address
Po Box 24686New York, NY 10087-4686
Phone 561-275-2020
Authorized official
Alisha Jackson
Senior Revenue Manager
5612081591
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