Organization
EYECARE ASSOCIATES, LLP
Active
Other names
Eyecare Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN F COUILLARD OD (PARTNER)
(309) 662-2277
Entity
Organization
Contact information
Practice address
2103 E WASHINGTON ST STE 1D, BLOOMINGTON, IL 61701-4365
(309) 662-2277
Mailing address
2103 E. WASHINGTON, SUITE 1D, BLOOMINGTON, IL 61701-4358
(309) 662-2277
(309) 663-6472
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
046007251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007251
—
IL
Enumeration date
10/09/2007
Last updated
08/20/2015
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