| |
1600 South Galena Ave, Dixon, IL 61021 | |
(815) 284-3935 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1600 South Galena Ave, Dixon, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699331082 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Kevin F Harte |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1336290253 PECOS PAC ID: 8325081813 Enrollment ID: I20050606000869 |
Provider Name | David J Anderson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1891747259 PECOS PAC ID: 7113939026 Enrollment ID: I20060614000191 |
Provider Name | Michael L Strasser |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1053411520 PECOS PAC ID: 1759380553 Enrollment ID: I20061205000237 |
Provider Name | Angelina M Popovic |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1063610822 PECOS PAC ID: 0840373635 Enrollment ID: I20080218000290 |
Provider Name | Joy H Goffron Kluge |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1275618589 PECOS PAC ID: 2668528878 Enrollment ID: I20090914000088 |
Provider Name | Dennis Lewinson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1952312878 PECOS PAC ID: 0941480297 Enrollment ID: I20110203000987 |
Provider Name | Alicja J Fitzgerald |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1124341375 PECOS PAC ID: 4789841396 Enrollment ID: I20120209000713 |
Provider Name | Thomas Christopher Esposito |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1194260414 PECOS PAC ID: 4284997297 Enrollment ID: I20180404000786 |
Provider Name | Sweatha Jeevan |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1992363360 PECOS PAC ID: 0345573184 Enrollment ID: I20190610001355 |
Provider Name | Katelyn Jo Steen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922655158 PECOS PAC ID: 8426387432 Enrollment ID: I20190916003162 |
Provider Name | Joseph Allen Herba |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265584247 PECOS PAC ID: 7416383443 Enrollment ID: I20200210002851 |
Provider Name | Eric Veverka |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1518580430 PECOS PAC ID: 1254751449 Enrollment ID: I20201008001141 |
Provider Name | Berta Newton |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1124540083 PECOS PAC ID: 9032526512 Enrollment ID: I20210330000322 |
Provider Name | Kathryn Lynn Wilson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023124518 PECOS PAC ID: 9739588997 Enrollment ID: I20210520002613 |
Provider Name | Jamie Elmore |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467008680 PECOS PAC ID: 9638562937 Enrollment ID: I20221117002749 |
Provider Name | Steven Ticknor |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174260715 PECOS PAC ID: 6002290202 Enrollment ID: I20221205001838 |
Provider Name | Megan Sales |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760151120 PECOS PAC ID: 5698172013 Enrollment ID: I20231127002263 |
Provider Name | Mikolaj Nowobilski |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285319020 PECOS PAC ID: 9335500164 Enrollment ID: I20240826002102 |
Mailing Address | Practice Location Address |
---|---|
Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 1600 South Galena Ave, Dixon, IL 61021 Ph: (815) 284-3935 |