Organization
PRAIRIE EYE CENTER, LTD
Active
Parent organization
PRAIRIE EYE CENTER, LTD
Other names
Jacksonville Ophthalmologic Associates 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
2000 W MORTON AVE, JACKSONVILLE, IL 62650-2623
(217) 245-6814
(217) 245-0375
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
036-051855
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
06/07/2007
Last updated
02/17/2021
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