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Organization

CENTRAL ILLINOIS OPTOMETRIC ASSOCIATES LTD

Active
Other names
Advanced Eyecare of Taylorville
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DENNIS W RABE OD (CEO)
(217) 824-4991
Entity
Organization

Contact information

Practice address
900 W SPRINGFIELD RD, TAYLORVILLE, IL 62568-1213
(217) 824-4991
(217) 824-5414
Mailing address
900 W SPRINGFIELD RD, TAYLORVILLE, IL 62568-1213
(217) 824-4991
(217) 824-5414

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006087
IL
152W00000X
Optometrist
046008024
IL
152W00000X
Optometrist
046008739
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001115000
BC BS GROUP NUMBER
IL
05
046006087
IL
05
046008024
IL
05
046008739
IL
01
410015009
BLACKMAN RAILROAD NUMBER
IL
01
410015010
RABE RAILROAD NUMBER
IL
01
410029982
SMOTHERS RAILROAD NUMBER
IL
Enumeration date
03/22/2007
Last updated
04/18/2011
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