Organization
CENTRAL ILLINOIS FAMILY EYECARE LLC
Active
Parent organization
CENTRAL ILLINOIS FAMILY EYECARE LLC
Other names
Bloomington Eye Professionals
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL ILLINOIS FAMILY EYECARE LLC
Authorized official
DR. DENNIS M BRTVA OD (OWNER)
(309) 213-9200
Entity
Organization
Contact information
Practice address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
(309) 213-9200
(309) 213-9300
Mailing address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
(309) 213-9200
(309) 213-9300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007731
IL
Other
Enumeration date
03/10/2017
Last updated
02/28/2022
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