Aeg Connecticut Professional Pllc | |
111 E 4th St Ste 440, Alton, IL 62002-6206 | |
(618) 462-9818 | |
(314) 741-4947 |
Full Name | Aeg Connecticut Professional Pllc |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 111 E 4th St Ste 440, Alton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023883675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Hope B Marandola |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548240146 PECOS PAC ID: 0446278550 Enrollment ID: I20051108000141 |
Provider Name | Frances E Sites |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1699746040 PECOS PAC ID: 1052496387 Enrollment ID: I20080311000590 |
Provider Name | Philip M Perrino |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639191588 PECOS PAC ID: 7113908500 Enrollment ID: I20080507000194 |
Provider Name | Shawn A Burns |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1912170408 PECOS PAC ID: 8729120746 Enrollment ID: I20100128000449 |
Provider Name | Helen Ambizas |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1376716860 PECOS PAC ID: 4183767023 Enrollment ID: I20100201000620 |
Provider Name | Thomas M Arnista |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811089188 PECOS PAC ID: 7416114467 Enrollment ID: I20120203000086 |
Provider Name | Sean West |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114062999 PECOS PAC ID: 3476642265 Enrollment ID: I20161010000931 |
Provider Name | Kimberly Bridget Raucci |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578030458 PECOS PAC ID: 3173867744 Enrollment ID: I20181208000035 |
Provider Name | Allison Raucci |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811600778 PECOS PAC ID: 8820460900 Enrollment ID: I20230220000367 |
Mailing Address | Practice Location Address |
---|---|
Aeg Connecticut Professional Pllc 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 | Aeg Connecticut Professional Pllc 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 |
Aeg Delaware Professional Pa Optometrist Medicare: Medicare Enrolled Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 | |
Dr. James Walter Lieber, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 401 Henry St, Alton, IL 62002 Phone: 618-465-6000 | |
Mark D. Wade O D P C Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 Fax: 314-741-4947 | |