Organization
FIRESIDE EYE CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA HEDDINGHAUS OD (OPTOMETRIST)
(217) 835-7724
Entity
Organization
Contact information
Practice address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Mailing address
600 S 8TH ST, BENLD, IL 62009-1446
(217) 835-7724
(217) 835-7611
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46009181
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460091814
—
IL
01
—
05927400
BCBS
IL
01
—
210902
MEDICARE GROUP
IL
01
—
419640
HEALTHLINK
IL
01
—
5275510001
ADMINASTAR
IL
01
—
P00184209
MEDICARE RR
IL
Enumeration date
10/11/2007
Last updated
01/16/2025
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