| Miller Eye Center Ltd | |
|
2995 Eastrock Dr Rockford IL 61109-1737 | |
| (815) 226-1500 | |
| (815) 484-9600 |
| Full Name | Miller Eye Center Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 2995 Eastrock Dr, Rockford, Illinois |
| Authorized Official Name and Position | Richard A Miller (PRESIDENT) |
| Authorized Official Contact | 8152261500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miller Eye Center Ltd 2995 Eastrock Dr Po Box 7267 Rockford IL 61109-1737 Ph: (815) 226-1500 | Miller Eye Center Ltd 2995 Eastrock Dr Rockford IL 61109-1737 Ph: (815) 226-1500 |
| NPI Number | 1750376638 |
|---|---|
| Provider Enumeration Date | 09/15/2005 |
| Last Update Date | 05/17/2012 |
| Medicare PECOS PAC ID | 4880662741 |
|---|---|
| Medicare Enrollment ID | O20040920000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750376638 | NPI | - | NPPES |
| 03606603 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 03606603 (Illinois) | Primary |
| Provider Name | Marlyn F Goldberg |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1629066519 PECOS PAC ID: 3072546837 Enrollment ID: I20050913000999 |
| Provider Name | Lori Wassman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982706636 PECOS PAC ID: 9335249556 Enrollment ID: I20070720000624 |
| Provider Name | Richard A Miller |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134127871 PECOS PAC ID: 3779551635 Enrollment ID: I20110711000050 |
| Provider Name | Ahmet Ozkok |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1174866495 PECOS PAC ID: 5799097911 Enrollment ID: I20150701000434 |
| Provider Name | Peter Joseph Gunther |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073597498 PECOS PAC ID: 8921091125 Enrollment ID: I20171121001098 |
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