| NPI | 1093854820 |
|---|---|
| Doing Business As | CENTRAL ILLINOIS VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | MARCUS S DERANIAN Owner 217-233-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036069820) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046009767) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 036069820) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 036069820) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-04-24 |