| Henderson Eye Center | |
|
2709 S Koke Mill Rd, Springfield, IL 62711 | |
| (217) 698-9477 | |
| (217) 698-9474 |
| Full Name | Henderson Eye Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2709 S Koke Mill Rd, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295802981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046-009151 (Illinois) | Primary |
| 152W00000X | Optometrist | 046008041 (Illinois) | Secondary |
| 207W00000X | Ophthalmology | 036-042254 (Illinois) | Secondary |
| Provider Name | Donald Wade Henderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578624573 PECOS PAC ID: 7315991981 Enrollment ID: I20050308000153 |
| Provider Name | Kevin L Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922236264 PECOS PAC ID: 6002969029 Enrollment ID: I20090807000461 |
| Mailing Address | Practice Location Address |
|---|---|
| Henderson Eye Center 2709 S Koke Mill Rd, Springfield, IL 62711 Ph: (217) 698-9477 | Henderson Eye Center 2709 S Koke Mill Rd, Springfield, IL 62711 Ph: (217) 698-9477 |
Monica Ryan, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2020 W Iles Ave, Springfield, IL 62704 Phone: 217-698-3030 Fax: 217-698-4728 | |
Dr. Timothy Edwards, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 121 N Grand Ave W, Springfield, IL 62702 Phone: 217-528-3233 Fax: 217-528-4511 | |
Molly Guithues, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3055 Wabash Ave, Springfield, IL 62704 Phone: 217-793-2273 Fax: 217-793-2278 | |
Dr. Scott Blomberg, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 121 N Grand Ave W, Springfield, IL 62702 Phone: 217-528-3233 Fax: 217-528-4511 | |
Premier Vision Center Llc Optometrist Medicare: Medicare Enrolled Practice Location: 6900 Preston Dr Ste A, Springfield, IL 62711 Phone: 217-697-8741 | |
Emily Beyer, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2020 W Iles Ave, Springfield, IL 62704 Phone: 217-698-3030 Fax: 217-698-4728 | |
James Patrick Walsh, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2300 W White Oaks Dr, Sam's Club Optical, Springfield, IL 62704 Phone: 217-698-7662 Fax: 217-698-7875 |