| Dr Jonathan Edward Micetich, OD | |
|
20 E North Street, Coal City, IL 60416-1087 | |
| (815) 634-4825 | |
| (815) 634-4938 |
| Full Name | Dr Jonathan Edward Micetich |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 30 Years |
| Location | 20 E North Street, Coal City, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740273754 | NPI | - | NPPES |
| 046008925 | Medicaid | IL | |
| 3232003 | Other | IL | BLUE CROSS BLUE SHIELD OF ILLINOIS |
| 5075840001 | Other | IL | NATIONAL GOVERMENT SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046008925 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Myeyedr Optometry Of Illinois Llc | 3577869965 | 57 |
| Provider Name | Myeyedr Optometry Of Illinois Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1245695378 PECOS PAC ID: 3577869965 Enrollment ID: O20160310001870 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jonathan Edward Micetich, OD 1950 Old Gallows Rd Ste 520, Vienna, VA 22182-3970 Ph: (703) 847-8899 | Dr Jonathan Edward Micetich, OD 20 E North Street, Coal City, IL 60416-1087 Ph: (815) 634-4825 |
J. Micetich, Od & Associates Family Eye Care Center P C Optometrist Medicare: Not Enrolled in Medicare Practice Location: 20 E North St, Coal City, IL 60416 Phone: 815-634-4825 | |
Patricia Helen Simpson, O. D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 20 E North St, Coal City, IL 60416 Phone: 815-634-4825 Fax: 815-634-4938 | |
Dr. Andrea Paradesi, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 20 E North St, Coal City, IL 60416 Phone: 815-634-4825 | |
Dr. Jennifer Wai-ling Chu, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 20 E North St, Coal City, IL 60416 Phone: 815-634-4825 | |
Myeyedr Optometry Of Illinois, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 20 E North St, Coal City, IL 60416 Phone: 815-634-4825 Fax: 815-634-4938 |