Organization
CENTRAL ILLINOIS OPTOMETRIC ASSOCIATES LTD
Active
Other names
Advanced Eyecare of Lincoln
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA S SMOTHERS-CHAMPLEY (CEO)
(217) 824-4991
Entity
Organization
Contact information
Practice address
623 PULASKI ST, LINCOLN, IL 62656-2825
(217) 732-9606
(217) 732-4580
Mailing address
623 PULASKI ST, LINCOLN, IL 62656-2825
(217) 732-9606
(217) 732-4580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008024
IL
152W00000X
Optometrist
046008739
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001115000
BC BS GROUP NUMBER
IL
05
—
046008024
—
IL
05
—
046008739
—
IL
Enumeration date
03/22/2007
Last updated
04/18/2011
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