Organization
SOUTHERN ILLINOIS EYECARE PLLC
Active
Parent organization
SOUTHERN ILLINOIS EYECARE, PC
Other names
Southern Illinois Eye Care, Sparta Eyecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN ILLINOIS EYECARE, PC
Authorized official
SCOTT POUYAT (PRESIDENT)
(847) 395-8885
Entity
Organization
Contact information
Practice address
520 E BROADWAY ST, SPARTA, IL 62286-1889
(618) 443-5252
Mailing address
520 E BROADWAY ST, SPARTA, IL 62286-1889
(618) 443-5252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
047931268
IL
Other
Enumeration date
01/24/2007
Last updated
05/29/2026
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