# PRAIRIE EYE CENTER LTD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRAIRIE EYE CENTER, LTD
- **Other names:** Prairie Retina Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730564261
- **Legal business name:** PRAIRIE EYE CENTER, LTD
- **Authorized official:** JASON LANG (BILLING ADMINISTRATOR)
- **Authorized official phone:** (217) 698-3030

## Contact information

- **Practice address:** 2020 W ILES AVE, SPRINGFIELD, IL 62704-4174
- **Practice address phone:** (217) 698-3030
- **Practice address fax:** (217) 321-2026
- **Mailing address:** 2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
- **Mailing address phone:** (217) 698-3030
- **Mailing address fax:** (217) 698-4728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | — |

## Other

- **Enumeration date:** 07/27/2015
- **Last updated:** 02/17/2021