Organization
PRAIRIE EYE CENTER LTD
Active
Parent organization
PRAIRIE EYE CENTER, LTD
Other names
Prairie Retina Center
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
2020 W ILES AVE, SPRINGFIELD, IL 62704-4174
(217) 698-3030
(217) 321-2026
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-4728
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
07/27/2015
Last updated
02/17/2021
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