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Organization

ONEOPTO IL 1 PLLC

Active
Other names
Southern Illinois Eye Care
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT POUYAT (PRESIDENT)
(847) 395-8885
Entity
Organization

Contact information

Practice address
520 E BROADWAY ST, SPARTA, IL 62286-1889
(618) 443-5252
(618) 443-2350
Mailing address
520 E BROADWAY ST, SPARTA, IL 62286-1889
(618) 443-5252
(618) 443-2350

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
09/23/2025
Last updated
09/23/2025
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