Organization
CENTRAL ILLINOIS VISION ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT CLARKE (OFFICER)
(217) 348-0800
Entity
Organization
Contact information
Practice address
620 6TH ST, CHARLESTON, IL 61920-2017
(217) 348-0800
(217) 348-0802
Mailing address
620 6TH ST, CHARLESTON, IL 61920-2017
(217) 348-0800
(217) 348-0802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008347
IL
Other
Enumeration date
02/03/2009
Last updated
01/09/2019
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