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Organization
MARION EYE CENTERS LTD.
Active
Organization
MARION EYE CENTERS LTD.
Active
Other names
Marion Eye Centers, Ltd.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAQBOOL AHMAD (PRESIDENT/OWNER)
(618) 993-3838
Entity
Organization
Contact information
Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-5595
Mailing address
1200 W DEYOUNG ST, P.O. BOX 1178, MARION, IL 62959-4437
(618) 993-5686
(618) 997-5505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
036-051996
IL
207W00000X
Ophthalmology Physician
Primary
036-051996
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
036.051996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051996
—
IL
05
—
203169800
—
MO
01
—
791580195
MEDICARE RAILROAD
—
01
—
CA2196 GROUP PTAN
MEDICARE RAILROAD
IL
Enumeration date
07/20/2005
Last updated
07/31/2017
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