| Edwardsville Vision Center | |
|
2100 Troy Rd, Edwardsville, IL 62025-2595 | |
| (618) 656-8888 | |
| (618) 656-8920 |
| Full Name | Edwardsville Vision Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2100 Troy Rd, Edwardsville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477703411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046010111 (Illinois) | Primary |
| Provider Name | Lisa M Kowar |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245371483 PECOS PAC ID: 9830082114 Enrollment ID: I20040205001045 |
| Provider Name | Chih Jen Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861443079 PECOS PAC ID: 3375433717 Enrollment ID: I20040617000538 |
| Provider Name | Mark D Wade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376512137 PECOS PAC ID: 8527043868 Enrollment ID: I20040622000116 |
| Provider Name | Michael E Robinson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295887602 PECOS PAC ID: 5092772186 Enrollment ID: I20041210000385 |
| Provider Name | Casey L Hogan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346233889 PECOS PAC ID: 7719945104 Enrollment ID: I20050103000237 |
| Provider Name | John W Kleinhoffer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992793103 PECOS PAC ID: 2961448055 Enrollment ID: I20050630000072 |
| Provider Name | Deana R Labrosse |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124068572 PECOS PAC ID: 6709810039 Enrollment ID: I20050926000396 |
| Provider Name | Roger H Hill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235212275 PECOS PAC ID: 2860417698 Enrollment ID: I20051012000042 |
| Provider Name | Richard E Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437232477 PECOS PAC ID: 1850316688 Enrollment ID: I20051012000057 |
| Provider Name | Leon F Kubicki |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043381882 PECOS PAC ID: 0446279400 Enrollment ID: I20051118000320 |
| Provider Name | Tiffany L Polanek |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952395014 PECOS PAC ID: 4880616911 Enrollment ID: I20060103000606 |
| Provider Name | Samuel J Forzley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144230392 PECOS PAC ID: 9537167382 Enrollment ID: I20061110000206 |
| Provider Name | John R Eigenbrodt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982602918 PECOS PAC ID: 1153423512 Enrollment ID: I20070305000055 |
| Provider Name | William Allen Watson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629132477 PECOS PAC ID: 1759487416 Enrollment ID: I20070426000458 |
| Provider Name | William C Hillmann |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629039789 PECOS PAC ID: 4688683386 Enrollment ID: I20070627000231 |
| Provider Name | Megan S Allen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306045083 PECOS PAC ID: 5193826519 Enrollment ID: I20070728000182 |
| Provider Name | Joseph W Aschenbrenner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841329786 PECOS PAC ID: 2961594163 Enrollment ID: I20070817000200 |
| Provider Name | Susan M Penner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891842464 PECOS PAC ID: 6406825918 Enrollment ID: I20070913000816 |
| Provider Name | Carol L Barron |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851497127 PECOS PAC ID: 5092899922 Enrollment ID: I20080229000554 |
| Provider Name | Ellen R Petroczky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992996383 PECOS PAC ID: 7810069234 Enrollment ID: I20080630000594 |
| Provider Name | Randall D Kittle |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871763839 PECOS PAC ID: 2466524350 Enrollment ID: I20080709000711 |
| Provider Name | Michael G Kennedy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417111790 PECOS PAC ID: 6305910340 Enrollment ID: I20080808000400 |
| Provider Name | Sung Y Kim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275623274 PECOS PAC ID: 4789750944 Enrollment ID: I20080912000023 |
| Provider Name | Charlene L Morfoot |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073798773 PECOS PAC ID: 9234298159 Enrollment ID: I20081107000048 |
| Provider Name | Jordan Phillip Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225293574 PECOS PAC ID: 1759441397 Enrollment ID: I20081126000590 |
| Provider Name | William H Opferman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659420818 PECOS PAC ID: 0941346159 Enrollment ID: I20091001000272 |
| Provider Name | Genine M Graff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376786111 PECOS PAC ID: 8921142597 Enrollment ID: I20100219000543 |
| Provider Name | Timothy J Leahy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629027958 PECOS PAC ID: 8527193986 Enrollment ID: I20100324000415 |
| Provider Name | Steven B Eiden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457342685 PECOS PAC ID: 1254353683 Enrollment ID: I20100716000389 |
| Provider Name | Christina J Levi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417924648 PECOS PAC ID: 2961536602 Enrollment ID: I20101007001075 |
| Provider Name | Toshio Nakajima |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609924745 PECOS PAC ID: 8729271242 Enrollment ID: I20101015001287 |
| Provider Name | Andrew J Neukirch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962666750 PECOS PAC ID: 5395811459 Enrollment ID: I20110513000406 |
| Provider Name | Erika K Cleland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740577956 PECOS PAC ID: 7214100957 Enrollment ID: I20111025000752 |
| Provider Name | Kurtis Carlson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104930601 PECOS PAC ID: 1557574902 Enrollment ID: I20120316000514 |
| Provider Name | Ryan S Thoele |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700144029 PECOS PAC ID: 9436313210 Enrollment ID: I20120606000557 |
| Provider Name | Robert S Gerowitz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023184520 PECOS PAC ID: 5799932471 Enrollment ID: I20120831000443 |
| Provider Name | Jonathon Paul Thoele |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114282548 PECOS PAC ID: 3870741838 Enrollment ID: I20120917000335 |
| Provider Name | Andrew James Brauer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316293590 PECOS PAC ID: 1850545799 Enrollment ID: I20130131000289 |
| Provider Name | Matthew Bluemlein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467707125 PECOS PAC ID: 2264679547 Enrollment ID: I20130503000311 |
| Provider Name | Jamie N Hogan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750320826 PECOS PAC ID: 1355379058 Enrollment ID: I20140211000108 |
| Provider Name | Jacqlyn E Long |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992866057 PECOS PAC ID: 2365546421 Enrollment ID: I20140410000325 |
| Provider Name | Michelle Man |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336528603 PECOS PAC ID: 8022321702 Enrollment ID: I20150723009515 |
| Provider Name | Natalie J Carr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235519190 PECOS PAC ID: 9830402478 Enrollment ID: I20150724011665 |
| Provider Name | Natalie Wozny |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013365188 PECOS PAC ID: 4284915430 Enrollment ID: I20161229001337 |
| Provider Name | Matthew J Odonnell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558800078 PECOS PAC ID: 2365726304 Enrollment ID: I20170310001752 |
| Provider Name | Christina Dalporto |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225422132 PECOS PAC ID: 3678850617 Enrollment ID: I20170501001209 |
| Provider Name | Javier R Rodriguez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275056236 PECOS PAC ID: 1456624550 Enrollment ID: I20170913000001 |
| Provider Name | Constance Copeland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508857202 PECOS PAC ID: 6002823564 Enrollment ID: I20170927000721 |
| Provider Name | Sarah L Rogers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548828296 PECOS PAC ID: 9335474543 Enrollment ID: I20190710002905 |
| Provider Name | Ayman Tabani |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013564111 PECOS PAC ID: 5698004034 Enrollment ID: I20190910001058 |
| Provider Name | Mubashra S Tahir |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972626240 PECOS PAC ID: 7012341910 Enrollment ID: I20191231002175 |
| Provider Name | Praksha A Butala |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447873260 PECOS PAC ID: 2466877543 Enrollment ID: I20200806001395 |
| Provider Name | Niki Mehta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407474166 PECOS PAC ID: 8224452289 Enrollment ID: I20201005000149 |
| Provider Name | Robert Fullenwider |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699386755 PECOS PAC ID: 0648698159 Enrollment ID: I20201014000165 |
| Provider Name | Theresa Marie Oliver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427588185 PECOS PAC ID: 5092125567 Enrollment ID: I20201208000576 |
| Provider Name | Priyanka Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316558570 PECOS PAC ID: 7517367303 Enrollment ID: I20210616001098 |
| Provider Name | Ashley Marvin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154774693 PECOS PAC ID: 8022306810 Enrollment ID: I20210917000007 |
| Provider Name | Shrey Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497378244 PECOS PAC ID: 3779971353 Enrollment ID: I20211101002292 |
| Provider Name | Arpit Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710595368 PECOS PAC ID: 1254729684 Enrollment ID: I20211103002715 |
| Provider Name | Raphaella Tran |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528636198 PECOS PAC ID: 1658763644 Enrollment ID: I20220125002152 |
| Provider Name | Lisha Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326474735 PECOS PAC ID: 7214165083 Enrollment ID: I20220429001643 |
| Provider Name | Matthew Kyle Mccoy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043835580 PECOS PAC ID: 5294157509 Enrollment ID: I20220610002194 |
| Provider Name | Himanee Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558006056 PECOS PAC ID: 1557743531 Enrollment ID: I20220808002339 |
| Provider Name | Amie Gandhi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780317453 PECOS PAC ID: 1052796612 Enrollment ID: I20220916003215 |
| Provider Name | Regino Flora |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750454393 PECOS PAC ID: 7810367752 Enrollment ID: I20230110001734 |
| Provider Name | Anna Pamula |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023728995 PECOS PAC ID: 4385016260 Enrollment ID: I20230203000180 |
| Provider Name | Jessica Garcia |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467130898 PECOS PAC ID: 1052773165 Enrollment ID: I20230821003070 |
| Provider Name | Ayhubrhan Yifru |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427749209 PECOS PAC ID: 1557717691 Enrollment ID: I20231026001777 |
| Provider Name | Katharine Schooley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154016848 PECOS PAC ID: 5193171148 Enrollment ID: I20231026002814 |
| Mailing Address | Practice Location Address |
|---|---|
| Edwardsville Vision Center 2100 Troy Rd, Edwardsville, IL 62025-2595 Ph: (618) 656-8888 | Edwardsville Vision Center 2100 Troy Rd, Edwardsville, IL 62025-2595 Ph: (618) 656-8888 |
Dr. Stephanie R Goggin, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6620 Center Grove Road, Edwardsville, IL 62025 Phone: 618-659-1900 Fax: 618-659-1901 | |
Edwardsville Vision Center Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2100 Troy Rd Ste 104, Edwardsville, IL 62025 Phone: 618-656-8888 Fax: 314-741-4947 | |
Lauren Bozsa, OD Optometrist Medicare: Medicare Enrolled Practice Location: 25 Dunlap Cove Dr, Edwardsville, IL 62025 Phone: 618-791-0513 | |
Ashley Ann Boatman, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2100 Troy Rd, Edwardsville, IL 62025 Phone: 618-656-8888 Fax: 314-741-4947 | |
Dr. Sarah Elizabeth Kruse, OD Optometrist Medicare: Medicare Enrolled Practice Location: 6620 Center Grove Rd, Edwardsville, IL 62025 Phone: 618-659-1900 | |
Dr. Jennifer Brave Rafati, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2100 Troy Rd Ste 104, Edwardsville, IL 62025 Phone: 618-656-8888 Fax: 618-656-8920 | |
Dr. Natalie J. Hutchison, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2100 Troy Rd, Edwardsville, IL 62025 Phone: 618-656-8888 |