| Fireside Eye Care, P.c. | |
|
600 S 8th St, Benld, IL 62009-1446 | |
| (217) 835-7724 | |
| (217) 835-7611 |
| Full Name | Fireside Eye Care, P.c. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 600 S 8th St, Benld, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447448717 | NPI | - | NPPES |
| 0460091814 | Medicaid | IL | |
| 05927400 | Other | IL | BCBS |
| P00184209 | Other | IL | MEDICARE RR |
| 419640 | Other | IL | HEALTHLINK |
| 5275510001 | Other | IL | ADMINASTAR |
| 210902 | Other | IL | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 46009181 (Illinois) | Primary |
| Provider Name | Jennifer M Waller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861440612 PECOS PAC ID: 7618955154 Enrollment ID: I20040710000271 |
| Provider Name | Shawna Lanette Heddinghaus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811982515 PECOS PAC ID: 4385695147 Enrollment ID: I20050214000812 |
| Provider Name | Dale J Swetlishnoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649233057 PECOS PAC ID: 1456350115 Enrollment ID: I20061207000365 |
| Provider Name | Claud R Snowden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235122466 PECOS PAC ID: 2264434653 Enrollment ID: I20070214000233 |
| Provider Name | Alicia Triplett Janssen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831487610 PECOS PAC ID: 3072785484 Enrollment ID: I20111007000093 |
| Provider Name | Amanda Kay Gerson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417514134 PECOS PAC ID: 9537493424 Enrollment ID: I20190626002995 |
| Mailing Address | Practice Location Address |
|---|---|
| Fireside Eye Care, P.c. 600 S 8th St, Benld, IL 62009-1446 Ph: (217) 835-7724 | Fireside Eye Care, P.c. 600 S 8th St, Benld, IL 62009-1446 Ph: (217) 835-7724 |
Dale J Swetlishnoff, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 600 S 8th St, Benld, IL 62009 Phone: 217-835-7724 Fax: 217-835-7611 | |
Dr. Shawna L Heddinghaus, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 600 S 8th St, Benld, IL 62009 Phone: 217-835-7724 Fax: 217-835-7611 |