Illini Optometric PC

Optometrist · Godfrey, IL

Organization Active NPI

NPI number 1780850032

Practice location

3300 Godfrey Rd
Godfrey, IL 62035
Phone
(618) 466-8787
Fax
(618) 466-4703

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NPI record

NPI
1780850032
Entity type
Organization (Type 2)
Enumeration date
May 7, 2008
Last updated
May 7, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X 060005314 IL

Mailing address

PO Box 5040
Godfrey, IL 62035
Phone
(618) 466-8787
Fax
(618) 466-4703

Authorized official

Name
Mark E Ferguson, OD
Title
President
Phone
(618) 446-8787

About Illini Optometric PC

Illini Optometric PC is a healthcare organization registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 3300 Godfrey Rd, Godfrey, IL 62035. The NPI number 1780850032 was assigned on May 7, 2008 and the record was last updated on May 7, 2008.

Illini Optometric PC lists a license in the registry: #060005314 (IL) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mark E Ferguson, OD, President.

Frequently asked questions

What is the NPI number of Illini Optometric PC?

The NPI number is 1780850032.

What is the phone number of Illini Optometric PC?

The phone number listed for the practice location is (618) 466-8787.

Where is Illini Optometric PC located?

3300 Godfrey Rd, Godfrey, IL 62035.

What is the taxonomy code for Illini Optometric PC?

The primary taxonomy code is 152W00000X – Optometrist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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