Individual
MR. JOSEPH BARRY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3323 FRONTAGE RD, PERU, IL 61354-1101
(815) 220-0652
(815) 220-0732
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9542
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46007341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215175
BLUE CROSS BLUE SHIELD
IL
01
—
CG4165
MEDICARE RAILROAD
IL
Enumeration date
10/19/2006
Last updated
01/08/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us