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Organization
MIDWEST EYE ASSOCIATES, LLC
Active
Organization
MIDWEST EYE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANCE P STEAHLY MD (OWNER)
(217) 529-3937
Entity
Organization
Contact information
Practice address
5220 S 6TH STREET RD, SUITE 2300, SPRINGFIELD, IL 62703-5735
(217) 529-3469
(217) 529-0968
Mailing address
PO BOX 9830, SPRINGFIELD, IL 62791-9830
(217) 529-3937
(217) 529-0968
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08432068
BCBS GROUP NUMBER
IL
Enumeration date
06/01/2007
Last updated
02/28/2008
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