| Marengo Vision Center, P.c. | |
|
313 N Division St, Harvard, IL 60033-3060 | |
| (815) 943-6635 | |
| Not Available |
| Full Name | Marengo Vision Center, P.c. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 313 N Division St, Harvard, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396940938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046-009334 (Illinois) | Primary |
| Provider Name | Michael W Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679539993 PECOS PAC ID: 9830177286 Enrollment ID: I20050309000843 |
| Provider Name | Jon W Russell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831177088 PECOS PAC ID: 4284637505 Enrollment ID: I20060807000010 |
| Provider Name | Jeffrey T Caron |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194701490 PECOS PAC ID: 2365558897 Enrollment ID: I20101012001255 |
| Provider Name | Javier R Rodriguez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275056236 PECOS PAC ID: 1456624550 Enrollment ID: I20170913000001 |
| Mailing Address | Practice Location Address |
|---|---|
| Marengo Vision Center, P.c. 313 N Division St, Harvard, IL 60033-3060 Ph: (815) 943-6635 | Marengo Vision Center, P.c. 313 N Division St, Harvard, IL 60033-3060 Ph: (815) 943-6635 |
Imran Ali, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 313 N Division St, Harvard, IL 60033 Phone: 815-943-6635 Fax: 815-943-6740 |