# MARION EYE CENTERS LTD.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marion Eye Centers, Ltd.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508865643
- **Authorized official:** DR. MAQBOOL AHMAD (PRESIDENT/OWNER)
- **Authorized official phone:** (618) 993-3838

## Contact information

- **Practice address:** 1200 W DEYOUNG ST, MARION, IL 62959-4437
- **Practice address phone:** (618) 993-5686
- **Practice address fax:** (618) 997-5595
- **Mailing address:** 1200 W DEYOUNG ST, P.O. BOX 1178, MARION, IL 62959-4437
- **Mailing address phone:** (618) 993-5686
- **Mailing address fax:** (618) 997-5505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 036-051996 | IL | — |
| 207W00000X | Ophthalmology Physician | 036-051996 | IL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | 036.051996 | IL | — |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 07/31/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036051996 | — | IL |
| 05 | — | 203169800 | — | MO |
| 01 | — | 791580195 | MEDICARE RAILROAD | — |
| 01 | — | CA2196 GROUP PTAN | MEDICARE RAILROAD | IL |