Bard Optical | |
8309 N Knoxville Ave, Peoria, IL 61615-2170 | |
(309) 693-9540 | |
Not Available |
Full Name | Bard Optical |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 8309 N Knoxville Ave, Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508856923 | NPI | - | NPPES |
7215175 | Other | IL | BCBS |
1508856923 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Sandra R Pelfrey-jones |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770589244 PECOS PAC ID: 9739176074 Enrollment ID: I20040428000760 |
Provider Name | Kenneth A Schaidle |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639166226 PECOS PAC ID: 0244228914 Enrollment ID: I20040503000538 |
Provider Name | Ronald L Richmond |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1184611766 PECOS PAC ID: 6507854221 Enrollment ID: I20040503000877 |
Provider Name | Mark D Hahn |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1528055969 PECOS PAC ID: 6305834979 Enrollment ID: I20040503001285 |
Provider Name | Robert P Edwards |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396753059 PECOS PAC ID: 4688662000 Enrollment ID: I20040504001374 |
Provider Name | Linda L Mahaffey |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1629004767 PECOS PAC ID: 6608866702 Enrollment ID: I20040512000984 |
Provider Name | Joseph B Jackson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1649352691 PECOS PAC ID: 4486621315 Enrollment ID: I20040910001174 |
Provider Name | Marc C Sarmiento |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932116449 PECOS PAC ID: 9335101245 Enrollment ID: I20041103000154 |
Provider Name | David R Morgret |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922109172 PECOS PAC ID: 5395785471 Enrollment ID: I20050509000235 |
Provider Name | Stacy A Twenhafel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407901051 PECOS PAC ID: 2466493390 Enrollment ID: I20050520000098 |
Provider Name | John J Rimkus |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346347044 PECOS PAC ID: 6406744457 Enrollment ID: I20070103000171 |
Provider Name | Brian D Henson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1184782112 PECOS PAC ID: 8325145683 Enrollment ID: I20070521000528 |
Provider Name | Sabrina M Shultz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1316086580 PECOS PAC ID: 5193826147 Enrollment ID: I20070720000747 |
Provider Name | Jeffrey S Heden |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770580797 PECOS PAC ID: 4486737657 Enrollment ID: I20080211000716 |
Provider Name | Keli E Jordan Gardner |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457374811 PECOS PAC ID: 3375678162 Enrollment ID: I20100318000433 |
Provider Name | Steven H Lane |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1952427262 PECOS PAC ID: 5698840866 Enrollment ID: I20110121000759 |
Provider Name | Rhonda Dameron |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1306952072 PECOS PAC ID: 6103038260 Enrollment ID: I20110214000422 |
Provider Name | Nicole M Jensen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790072924 PECOS PAC ID: 8123298718 Enrollment ID: I20110909002793 |
Provider Name | Dinita Cooley |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1831486901 PECOS PAC ID: 9739337387 Enrollment ID: I20120924000622 |
Provider Name | Yolanda Arce Montijo |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1063491553 PECOS PAC ID: 2961423520 Enrollment ID: I20140306000478 |
Provider Name | Kaitlin Renae Griffith |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760894935 PECOS PAC ID: 2961628581 Enrollment ID: I20140716002589 |
Provider Name | Molly M Guithues |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023480316 PECOS PAC ID: 3274843974 Enrollment ID: I20151110000140 |
Provider Name | Sharna Annise Wiltz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407019946 PECOS PAC ID: 3072877711 Enrollment ID: I20180507000086 |
Provider Name | Kavita Patel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962022384 PECOS PAC ID: 6406273655 Enrollment ID: I20200902001197 |
Provider Name | Tesia Reed |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104388800 PECOS PAC ID: 4981023124 Enrollment ID: I20201007002125 |
Provider Name | Shweta R Harvi |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1033781562 PECOS PAC ID: 4880099860 Enrollment ID: I20210830001769 |
Provider Name | Zahra Tahir |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396411195 PECOS PAC ID: 3971901703 Enrollment ID: I20211008002055 |
Mailing Address | Practice Location Address |
---|---|
Bard Optical 8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 693-9540 | Bard Optical 8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 693-9540 |