Organization
PRAIRIE EYE CENTER LTD
Active
Parent organization
PRAIRIE EYE CENTER LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRAIRIE EYE CENTER LTD
Authorized official
JASON LANG (BILLING ADMINISTRATOR)
(217) 698-3030
Entity
Organization
Contact information
Practice address
106 E MAIN ST, BEARDSTOWN, IL 62618-1241
(217) 323-1146
(217) 323-1145
Mailing address
106 E MAIN ST, BEARDSTOWN, IL 62618-1241
(217) 323-1146
(217) 323-1145
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
042000760
IL
207W00000X
Ophthalmology Physician
—
—
Other
Enumeration date
07/22/2009
Last updated
02/17/2021
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